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Student Check-In Form
We know that you may have questions/comments/concerns or just need to talk to a school counselor. Please fill out the following form, so that we are able to get in touch with you. Please allow up to 48 hours for a response.
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* Indicates required question
ID NUMBER
*
Your answer
LAST NAME
*
Your answer
FIRST NAME
*
Your answer
Email Address
Your answer
Best Telephone Number
*
Your answer
Who is your school counselor?
*
Choose
Dr. Chevalier - 9th Grade (A-F) & 12th Grade
Ms. Jasper - 9th Grade (G-M) & 10th Grade
Ms. Wright - 9th Grade (N-Z) & 11th Grade
Grade Level
Choose
9th
10th
11th
12th
HOW ARE YOU FEELING?
*
Choose
Happy
Sad
OK
Concerned
Worried
Frustrated
Question/Comment/Concern (if it is too personal to share, please write personal and we can discuss it when we make contact)
Your answer
What is the best time to reach you?
*
8:00 a.m. - 10:00 a.m.
10:00 a.m. - 12:00 p.m.
12:00 p.m. - 2:00 p.m.
2:00 p.m. - 4:00 p.m.
How would you like the school counselor to contact you?
*
Email
Phone Call
Video Chat (if available)
Submit
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