GROUP COUNSELING INTEREST FORM
Groups are great for students interested in working through some areas of concern in their lives. Please complete this form if you are interested in participating in a group. Note that groups are voluntary, and students must agree to participate.
Student Last Name *
Your answer
Student First Name *
Your answer
Student ID Number
Your answer
Grade Level *
Student E-Mail Address: *
Your answer
Please select the group(s) you are interested in: *
You may check as many groups as apply.
Required
Other:
If you are interested in another group, or have other comments, please let us know.
Your answer
STUDENTS: By checking below you certify that you are completing this questionnaire for yourself only, not another student.
PARENTS: By checking below you certify that you are completing this form for your own son or daughter, not for any other student. This is a voluntary group, therefore, your student must agree to attend this group.
Date completed: *
Your answer
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