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Seeds of Excellence Christian Academy
Counselor Request Form (2023-2024)
Please complete the form below to refer scholars to meet with the counselor.
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* Indicates required question
Student Name
*
Your answer
Student Grade
*
Choose
Kindergarten
1st
2nd
3rd
4th
5th
6th
Reason for referral
*
Academic
Social/Emotional
Personal -(friends, family, home)
Brief description for referral (optional)
Your answer
Referred by
*
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