EDS 128B/139 Spring 2017

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First Name *

Last Name *

PID *

Zip Code *

Email *

Select the EDS Course(s) you have taken in the past: *

EDS 130

EDS 131

EDS 136

EDS 137

Required

Quarter and Year EDS PAL course taken: *

Fall 2016

Spring 2016

Winter 2017

Other

Required

List the school site(s) you were placed at in your prior PAL (EDS 130-137) courses:

What grade level(s) were you placed in (check all that apply) *

Preschool

Grade K-2

Grade 3

Grade 4

Grade 5

Middle School (6-8)

High School (9-12)

Required

Current 128A Placement *

If available, would you like to be placed in a bilingual (Spanish) class? *

Yes

Required

Are you completing the P-3 focus? *

The P-3 focus emphasizes educational development from preschool to 3rd grade

Yes

Required

Do you have a car? *

Yes

Required

Will you be carpooling with a classmate? *

At least one member of the carpool must have a car.

Yes

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