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Ms. Kerpa Counseling Request
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Email
*
Your email
Student First Name:
*
Your answer
Student Last Name:
*
Your answer
Grade:
*
Freshman
Sophomore
Junior
Who is your Advisor Teacher?
*
Choose
Anfinson
Ferris
Holmes
Murray
Paskey
Pritchard
Sampson
Waldbillig
Canright
Curtiss
Dearborn & Clarkson
Elwood
Harris
Huschka
Schoenfeld
Bender
Cobb
Jeno & Schoppe
Knight
Mitchell
Moore & Charlton
Ridgeway
What do you need to see me about?
*
Friend / Relationship Concern
Schedule Question / Change
Academic Concern
Personal Concern
Home Concern
Other:
How soon do you need to see me?
*
RIGHT NOW! It's urgent
I'd like to see you within the next few days
It's not urgent...I can wait until your next opening
A copy of your responses will be emailed to the address you provided.
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