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Pine View Middle School Counseling Sign-In
CONFIDENTIAL
Please sign in before meeting with a counselor and we'll call for you as soon as possible.
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1. Name
*
Your answer
2. Cell number or email
Your answer
3. Grade Level
*
8th Grade
9th Grade
4. Visit with Whom?
*
Chuck Bundy, 9th grade Counselor
Reen Sorensen, 8th grade Counselor
Terry Moore, Wed. Counselor, Character Ed
PEP Teresa, groups
Fred Brewer, LCSW, Individual
Dre Smith, ETS, DSU
Tyler Gordon, CJC
Other:
5. Purpose of Visit
*
Academic (grades, sch change, attendance, intervention help, school help)
Personal
College, Scholarships, CCR's, Future Planning, Career Clusters, Pathways
6. Add additional info (Confidential)
Your answer
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