Counselor Request Form
We are still here to help you even if it is not in person. If you would like to visit with your counselor, please fill out this form. Our office hours are Monday - Friday from 9:00 am - 1:00 pm.

Mrs. Schultz (last names A-L)
Mrs. Jones (last names M-Z)
What is your name? (First and Last) *
Your answer
Student ID *
Your answer
What grade are you in? *
What is your school username? (what you use to log into your computer) *
Your answer
Reason for request
How would you prefer for your counselor to contact you? *
If you wish to receive an email or have a video-conference, what is the best email to reach you at?
Your answer
If you wish to receive a text or phone call, what is the best number to reach you at?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy