Parks Junior High - Request for Assistance
This form is to be utilized for requesting assistance at Parks Junior High School for academic, behavioral, and/or social-emotional concerns for a particular student. The form below may be completed by a family member or a student at Parks Junior High.

This form is only available electronically.

The Request for Assistance form will be submitted to the principal, assistant principal, and school counselor who will communicate with the PBIS Team to determine best interventions that will support the student.
Student First Name, Last Name *
Your answer
Student ID # *
Your answer
Date *
MM
/
DD
/
YYYY
Grade *
I am a (choose one): *
Name of person filling out the form: *
Your answer
Relationship to student: *
Your answer
Type of concern (Check all that apply): *
Required
Please describe in detail the type of concern stated above: *
Your answer
Submit
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