Request to See a Counselor 2019-20
Please fill out this form and your counselor will call you out or send an appointment slip in the next two days.
Jessica Calderon (CAPA and Health 10th-12th,)
Christina Rios (Multimedia 10th-12th; ELD 1-2; Internationals)
Rachelle Buckner (Law and Engineering 10th-12th)
Maya Brown (All of 9th grade)
Ivan Rodriguez (intern)
My Counselor is....
a student/un estudiante
a parent or guardian/ un padre o tutor
Student First Name/ Primer Nombre
Student Last Name/ Apellido
Student ID number /Numero de Identificacion
Personal email address/ Correo Electronico
This is different than your school email. Please provide your personal email so we can email your directly. Este es tu correo electronico personal, no la de la escuela.
I need to see my counselor about
A-G requirements and college information/ Informacion sobre requisitos de universidad
Advice about how to improve my grades/Apoyo para mejorar mis calificaciones
Credit and transcript analysis/ repaso de mi historial y creditos
A personal issue/ un asunto personal
Describe reason for appointment. Describe la razon por esta solicitud.
Please use complete sentences and details. Do not say "I want to change classes". Instead, tell us which specific class, which period, which teacher and at least one complete sentence with your reason. Providing details will help us gather the correct information before we meet with you.
Never submit passwords through Google Forms.
This form was created inside of West Contra Costa Unified School District.
Terms of Service