Student Services Request

Complete this form if you have a question or need to see your counselor.

****If this is an emergency (you or someone else may be hurt, see an adult now and let them know).

Student Name Student Name First Last
Student ID#
Email Address
Reason/Request

Reason/Request Credit Recovery/APEX On-Line Course Approval ACT/SAT Waiver request ACT/SAT Info needed Schedule/Class Concern Personal Other Other
For Schedule/Class Concern, select from choices below to help us understand the issue:

For Schedule/Class Concern, select from choices below to help us understand the issue: I have been placed in a course I do not meet the pre-requisite for. I have been placed in a course and believe I meet the requirements to be in a higher level (ie. Honors). I already took a course and need to be switched into a different course. Other: Other:
Provide summary with details below: