Mrs. Bernice Ulibarri (Last Names D-Hi)

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If you or someone you know are in crisis, please do not fill out this form. If it is an emergency, call 911. If it is not an emergency and during school hours, please come directly to the front office and talk to a staff member. If it is after school hours, please call the NM Crisis Line at 855-662-7474 or text the work HOME to 741741.Joh

Last Names *

First Name *

ID# *

Email Address (do not use your APS email address)

Cell Phone Number *

Grade Level *

9th

10th

11th

12th

Are you on campus or virtual? *

On Campus

Virtual

Which one best describes what you would like to talk to the Counselor about? *

Academic Support

Career/College Planning

Letter of Recommendation

Personal/Emotional Support (if this is an emergency do not fill out this form, talk to someone in the office immediately)

Schedule Correction

eCademy/Summer School

Other:

Please type a brief message for Mrs. Ulibarri so she can better assist you. *

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