Staff Equity Support Form

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We recognize that the global events occurring every day may impact your classroom environment. Conflict may arise, and resources on deescalation and reestablishing an inclusive and respectful learning environment may be needed. Please take a moment to complete the Staff Equity Support Form to utilize Support Services.

Email *

First Name *

Last Name *

High School *

Alan B. Shepard High School

Dwight D. Eisenhower High School

Harold L. Richards High School

DELTA/SUMMIT Learning Center

Phone Number *

How you prefer to be contacted: *

School Email Address

Phone (call)

Phone (text)

Required

Please explain why you have contacted the Support Team. *

Please rate your stress now on a scale of 1-10 (1 is low and 10 is high) in relation your reason for reaching out to the Support team. *

Anger

Anxiety

Sadness

Fear

Frustration/Anguish

Please share the types of support you would like to potentially receive. The support my be delivered virtually or in-person. *

Peer Mediation for Students

Conflict Resolution Strategies for the Classroom

Collaborative Classroom Meeting with Support Staff

Counseling Resources for your Personal Utilization

Other:

Required

If you marked "Other" for the type of support you need, please specify how we may assist you.

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