Counselor Request Form
Please complete this form to request an appointment with Ms. Tharpe.
Email address *
My last name is:
Your answer
My first name is:
Your answer
My Birthdate (dd/mm/yyyy) is:
Your answer
My grade is:
I would like to see my counselor regarding:
Please tell your counselor a little bit about your reason to see the counselor.
Your answer
Please include an email address that you check regularly. Ms. Tharpe may respond via email.
Your answer
Thank you for submitting your counselor request online.
You should receive a response or be called in by Ms. Tharpe within two days.
A copy of your responses will be emailed to the address you provided.
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