Middle School Counseling Request Form
Students and Parents: If you need any assistance from your school counselor, please complete this form. We will be utilizing this as just one simple way for you to get into contact with us during the school closure due to COVID- 19. You may also email Mrs. Klepper at cklepper@wahoowarriors.org (for 6th graders) or Mr. Harris at jharris@wahoowarriors.org (for 7th-8th graders). This can be a difficult time for all of us, but we want you to know there are resources and people to help you, if you need it.
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Student Name (First and Last Name) *
Student Grade *
I need assistance with (check all/any that apply) *
Required
If you'd like, you can include - in your own words - a very brief description of what you need assistance with:
How would you like Mrs. Klepper or Mr. Harris to contact you? *
Required
Please list your phone and/or email that we can contact you at: *
What is the best time of day to reach you? *
Required
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