Gateway Counseling Department Requests Q4
Please complete this form to request an appointment with your counselor.You will be sent a pass with an appointment time.
* Required
Your First Name
*
Your answer
Your Last Name
*
Your answer
I am a
*
student
parent/guardian
Other:
Required
Contact information (enter your cell number, email address, or other contact information here)
Your answer
Student ID # (if applicable, otherwise write N/A)
Your answer
Language preference
Your answer
Grade
*
9th
10th
11th
12th
Other:
Who do you need to see?
*
Choose
Shannon Wachsmann (Students with last names A-C and ELD 1 & 2 students)
Elizabeth Felker (Students with last names D-K)
Denise Gettel-Capone (Students with last names L-Q)
Chance Siegele (Students with last names R-Z)
Other/unknown
When would be the best time to talk? (Counselors will do their best to honor your request, but may need to make an exception. Check all that apply.)
*
Period 1
Period 2
Period 3
Period 4
Period 5
Period 6
Period 7
Lunch
Late Start Wednesday
Mornings
Afternoons
Other:
Required
What are you interested in talking about?
*
Schedule (only after 1st 2 weeks-prior complete yellow form)
ED 20/20/Credit Recovery
College Applications
Scholarships
Personal Issue or Question
Pickens Technical College
Community College of Aurora (concurrent enrollment)
Atlernate Placement (Rebound, APS Online)
Transcript/Credits
Other:
Required
Please tell us more about what you would like to discuss (for example, what class/program are you wanting to change and why; description of question issue) The more information you can provide, the better we can meet your needs. :
Your answer
Submit
Page 1 of 1
Never submit passwords through Google Forms.
This form was created inside of APS Google.
Report Abuse
-
Terms of Service
-
Additional Terms
Forms
