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Dos Palos High School Counseling request
* Indicates required question
Email
*
Record my email address with my response
Choose your counselor
*
Mrs. Foster - Junior and Senior Classes
Mr. Jakobczak - Freshmen and Sophomore Classes
Ms. Lopez - Intervention Counselor
First and Last Name
*
Your answer
Email address
*
Your answer
Date of Request?
*
MM
/
DD
/
YYYY
Grade
*
Freshman
Sophomore
Junior
Senior
Reason for Request
*
Academic/ Schedule Change
Personal/Emotional
Social
Career
Other:
Briefly State Reason For Request
*
Your answer
Send me a copy of my responses.
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