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FCHS & CMS YSC NTI 2.0 Referral Form
Please Use this Google Form to seek assistance from the Fern Creek High & Carrithers Middle YSC During NTI 2.0
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* Indica que la pregunta es obligatoria
School Student Attends
*
Fern Creek High School
Carrithers Middle
Student Name
*
Tu respuesta
Student Grade
*
6th
7th
8th
9th
10th
11th
12th
Person Making Request
*
Student
Parent Guardian
Teacher/Administrator
Otro:
Your Contact information: Name, Relation to Student, Email and/or Phone Number
*
Tu respuesta
Seeking Help, Resources, Information on...(Select All that Apply)
*
School Supplies
Food Assistance
Clothing Assitance
Health or Social Services Referrals
Mental Health Referrals
Attendance Support
Homelessness Support
College & Career Information
KHEAA Support
Adult Continuing Education (GED) Referrals
Drug & Alcohol Abuse Prevention & Counseling Services
Holiday Assistance
Other
Obligatorio
Any Other Questions or Information you would like to share before we contact you.
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