Request To See Mrs. Seely

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Please fill out this form if you would like to see Mr. Strickler in the School Counseling Office.

Feel free to send Mrs.Seely an email at tara_seely@colonialhts.net if you have a question. Otherwise, allow her 2-3 class blocks to respond to this request. If you have not received a pass, please check your email before asking to come to the Counseling Office.

Please Note: This form is only monitored during school hours.

If it is an emergency, please ask your teacher to come to the School Counseling Office.

Student Name *

Grade *

9th

10th

11th

12th

Student Email:

Reason for Request: *

Academic (Classes, course request, attendance)

College/Career

Personal/Social

Other

Required

Any additional information? (Optional)

Please do not include any confidential information in this form.

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