Hi there! We are Middlebury College students who are hoping to be available to help out anyone in need of a shoulder to cry on, a listening ear, or a hand to hold. Whether you're looking for an objective point of view or someone to just sit and listen for a while, we're here. Please fill out this form so we can better assist you, and find times & ways that we can contact you. Any information you share will be confidential, and will remain between you and us (that is, as long as we do not feel that you are in any immediate danger of harming yourself or someone else).

*If you are in distress, please call the CSAC 24-hour emergency line at (802)388-7641 for immediate assistance!*
What is your first name? *
What is your graduation year? *
What do you want to talk about?
Please specify any particular issues you feel comfortable elaborating on, or provide a simple answer (e.g., stress, depression, just looking for a friend, etc.)
Indicate times you are available:
Please specify ALL times you are available (i.e., not in class, not asleep, not engaged in extra-curriculars, etc). Please indicate times as follows. Day of the week followed by: Early Morning (2AM-7AM), Morning (7AM-12PM), Afternoon (12PM-5PM), Evening (5PM-10PM), or Late Night (10PM-2AM). Example: Monday Afternoons, Tuesday Evenings, and Thursday Late Nights.
Contact Information *
Please provide contact information (phone number, e-mail, etc.)
How would you prefer that we contact you? *
Check all that apply.
What is your Middlebury box number?
We aren't going to use this to stalk you, we promise! But we may send you occasional surprise gifts in the mail!
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