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2020-21 Buckman Student Support Request
Are you looking for extra support for you or your Buckman student? Please complete the survey below and someone from Buckman will follow-up with you.
If you have any questions, please contact Katie Olson at 503-858-0230 or
kolson@impactnw.org
.
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* Indicates required question
Your name
*
Your answer
Student name
*
Your answer
Resources needed (check all that apply)
*
Academic assistance
Social-emotional support
Therapy/counseling
Basic needs
Skill-building
Connection
Other:
Required
What is the best way to contact you? Check all that apply.
*
Phone call
Email
Home visit
Text message
Other:
Required
Please provide your contact information below.
*
Your answer
Please provide a few details about the needs noted above. Anything else the support team should know?
Your answer
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