MS Self-Confidence Group Sign-up

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Hello! Thank you for your interest in the Middle School Self-Confidence small group with your School Counselor! :)

The goal of our group is to build your self-confidence, self-esteem and self-worth. We will meet a total of five times for five weeks in a row. These sessions will not be recorded to respect the privacy of our students.

Please fill out the form and the student and Learning Coach will be emailed soon with details. I look forward to working with you!

Referring Person *

I am signing myself up for this group.

I am signing my child up for this group.

I am referring a student for this group.

Student First Name *

Student Last Name *

Student ID *

Learning Coach Name *

Learning Coach Email Address *

Grade *

Required

Please choose the BEST session time to show up on your CC schedule. Our group will meet once a week, but two time slots are offered to keep our groups smaller. If you are not sure, you may choose both to show up on your schedule and can attend either one that works best for you that week. I recommend trying to attend the same session each week so you can get to know other students in your group. *

Wednesdays @ 12:00

Wednesdays @ 1:00

Both

Is there anything you would like me to know about yourself/your child?

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