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Assistance Form
Please fill out the information below so we can best understand how to help you. Thank you!
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Email
*
Record my email address with my response
Person filling out this form:
*
Your answer
Who is needing services:
*
Self
My Student
Staff/Faculty
Required
Campus:
*
Primary
Elementary
Intermediate
Middle School
High School
Required
Which area are you needing assistance in:
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Supportive Guidance (Individual Support, Small Group Activities, Crisis Management)
Academic Assistance (College Assistance, Study Skills)
Basic Needs (School Supplies, Clothes, Food)
List of Local Resources
Required
Contact Information:
*
Your answer
Brief description of your situation:
*
Your answer
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