Counselor Request Form
Please complete this form to request an appointment with Ms. Tharpe.
My last name is:
My first name is:
My Birthdate (dd/mm/yyyy) is:
My grade is:
I would like to see my counselor regarding:
My class schedule
An issue with peers
A family issue
A personal concern
Please tell your counselor a little bit about your reason to see the counselor.
Please include an email address that you check regularly. Ms. Tharpe may respond via email.
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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This form was created inside of Valverde.edu.