Dana Middle School - 5th Grade Schedule Planning Form 2024-2025 School Year
Please read the following instructions carefully.

Students and parents are encouraged to complete this form together.  

Please fill out all required fields including child's first and last name.
Five elective choice must be selected with elective choice one being the students top preference.
You must select five DIFFERENT elective choices.  

Students are NOT guaranteed their choices. Class availability will depend upon staffing and student interest, and we will do all we can to accommodate preferences.  

Complete this form by Friday, December 15th. Failure to complete this form, or failure to comply with the instructions above, will result in elective placement by the Counselor.

Choose your electives thoughtfully.  Review the elective descriptions on this page prior to making your decision: https://sites.google.com/sandi.net/danavirtualcounselingcenter/electives. You can also watch our elective video: https://drive.google.com/file/d/1QkiHAxHCGJ3wfV2maIMOGOmXYySjzHZz/view?usp=sharing 

  Students requesting ASB should complete the ASB Application by 12/15/23.
ASB Elective Questionnaire (google.com)

Students requesting Journalism should complete the Journalism application by 12/15/23. https://forms.gle/qPDe9EQ8jRwbsiw27


Students requesting Advanced Band must have approval from Mr. Rielan. You must email him at jrielan@sandi.net and let him know what instrument/instruments you play. 

Review your choices carefully.  Once you press submit, your elective choices are locked in.  
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Student First Name
 *
Student Last Name
 *
Student ID Number *
Your ID number is the number you enter each day when you login to google, student computer, or your online classroom.
Parent First and Last Name *
Parent Phone Number *
Parent Email  *
Your Current Elementary School *
4th Grade Teacher's Name *
Please check box below if you do not plan on attending Dana for the 24/25 school year.
Elective Choice One *
Elective Choice Two *
Elective Choice Three *
Elective Choice Four *
Elective Choice Five *
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