Counselor request form
Students please use this form to request a meeting with a counselor. We will get back to you as soon as possible.
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Email
*
Your email
Todays Date
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MM
/
DD
/
YYYY
I am a
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Student
Parent or Guardian
Student's name (First and Last)
*
Your answer
Grade
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6th Ms. Baker
7th Ms. Mehmen
8th Mr. Cole
Do you have a problem today?
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Yes
No
Yes and it's urgent (someone or myself is in danger, or I am extremely upset about something)
Is this a scheduling issue?
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Yes
No
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.
*
Your answer
A copy of your responses will be emailed to the address you provided.
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