Online COST Referral 2018-2019
Please complete this Google Form to make a COST referral for a student.
Email address *
Today's Date *
MM
/
DD
/
YYYY
Student's Name, Last Name, First *
Your answer
Student's Grade *
Required
Student's ID Number *
Your answer
Student's Counselor *
Required
Reason for Referral *
Required
Short Explanation of Concern *
Your answer
Name of Person Referring *
Your answer
Thank you for your concern and for taking your time.
Time
:
Submit
Never submit passwords through Google Forms.
This form was created inside of Hayward Unified School District. Report Abuse - Terms of Service