Liberty High School Request for Support
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* Required
Email address
*
Your email
Name of person requesting support
*
Your answer
Name of student in need of support
*
Your answer
Student's 6 digit number (if known)
Your answer
Counselor (if known)
Your answer
Grade
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9th
10th
11th
12th
Person requesting services
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Self
Family member
Teacher
Staff member
Friend
Other:
Select Appropriate Concern for Request
*
Academic
Social-Emotional/ Behavioral
Other:
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