WNSS Student Support Request Form

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It is important for WNSS students to know the supports available to them, and be able to self-refer in a discrete way.
Please select your requested support from the list below and they will call you down from class as soon as they are able.
(Your request will be confidential to the In-School Student Success Team Staff)

THIS IS NOT AN EMERGENCY SERVICE - if you are in an emergency situation, please call 911 immediately. This service will lead to an appointment/conversation with student supports staff.

Name (First and Last): *

Grade *

Grade 9

Grade 10

Grade 11

Grade 12

Reason for appointment (please be as detailed as possible) *

I would like to speak with: *

Guidance (Ms. Ebert, Mrs. Walton, Ms. Mokrzynski, Ms. McCready - eg. timetable questions or postsecondary planning)

Student Success (Mrs. Zombolas - tutoring, classroom success)

Resource Support (Ms. Barnett, Ms. Badawey, Mr. Gemella - IEP and IPRC)

Youth Counsellor (Yvonne - social/emotional supports and counselling; available Monday, Wednesday, and Friday))

Social Worker (Sarah - Select if you have seen her already, otherwise select Youth Counsellor)

Community Addiction Services Counsellor (CASON)

School Nurse (Megan)

Principal/Vice-Principal (Ms. Sargeant/Mr. Daniels/Ms. Leng-Marini/Mr. Whittington)

Unsure

Required

Optional: Period you would like to be called down

Period 1

Period 2

Period 3

Period 4

Period 5

Other:

Clear selection

Please list a phone number where you and/or your parent can be contacted. *

Please list an email where you and/or your parent can be contacted.
*

Submit

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