Liberty High School Request for Support
This information will be kept confidential.
* Required
Email address
*
Name of student in need of support
*
Person requesting services
*
Family Member
Student/ Friend
Self
Other:
Type of Concern (Check all that apply)
*
Academic
Emotional
Possible substance abuse (this will not result in disciplinary actions)
Other:
Required
Briefly describe the reason for request.
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Kern High School District.
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