ECG Counselling Appointment Request Form
Please fill in this form to make an appointment with the ECG Counsellor.

For self-referrals, students can fill in and submit this form personally. Please note that your form teacher will be informed of your booked session.

For referred cases, teachers are to fill in and submit this form with your student's particulars.

Source of Request
1. Select the source of this appointment request. *
Student's Particulars
2. Name of School *
Your answer
3. Name of Student *
Your answer
4. Gender *
5. Level *
6. Stream *
7. Class *
Your answer
8. Email Address *
(Confirmed date, time and venue of session will be sent to this email address for self referrals.)
Your answer
9. Mobile number *
Your answer
10. Counselling Session *
11. Name of Student's Form Teacher *
Your answer
12. Areas of Discussion with ECG Counsellor *
(You may choose more than one option.)
13. Please provide any other information that you will like the ECG Counsellor to know before the session.
Your answer
14. Preferred time slots for counselling session *
Please note that the ECG Counsellor will only be in your school once a week: Monday: KC Tuesday: TKGS, Wednesday: Broadrick, Thursday: TKSS
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