Counselor request form

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Students please use this form to request a meeting with a counselor. We will get back to you as soon as possible.

Email *

Todays Date *

YYYY

I am a *

Student

Parent or Guardian

Student's name (First and Last) *

Grade *

6th Mr. Cole

7th Ms. Baker

8th Ms. Walker

Do you have a problem today? *

Yes

Yes and it's urgent (someone or myself is in danger, or I am extremely upset about something)

Is this a scheduling issue? *

Yes

What is it that you would like to talk about today? If it is a schedule change request please let us know the class exploratory class you would like to change and your top 3 exploratory classes that you prefer to have on your schedule. For non-emergent issues, we will try our best to get back to you within one business day. *

A copy of your responses will be emailed to the address you provided.

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