I Need to Speak to a Counselor

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Filling this out lets Mrs. Jenkins know that you have something you need to talk about or you need help with something. She will contact you as soon as possible.

Al llenar esta forma, le deja saber a, la Sra. Jenkins que necesita hablar con ella o que necesita ayuda con algo. Ella se comunicará con usted lo antes posible.

Email *

Your Name / Su Nombre *

Your Teacher's Name / Nombre de su Maestra *

Reason for wanting to see the counselor / Razon por la que quiere ver a la consejera *

Worried or having trouble at school / Preocupacion o problemas escolares

Worried or having trouble at home / Preocupacion o problemas en casa

Having trouble with another student / Problemas con otro alumno

Having trouble with an adult / Problemas con un adulto

Our family needs help with food or clothing. / Nuestra familia ocupa ayuda en conseguir comida o ropa.

Other / Otra cosa

Required

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