Please Note:  Due to changes in technology, this form is currently inactive.  We apologize for the inconvenience.  We are currently exploring possible solutions.  MA, 9/1/2010   If you would like an appointment with your counselor, please fill in this form and then click "Submit" at the bottom of this page.  
Your counselor will receive an e-mail with this information.

Date: 

Student Name.   (If this involves two students, please enter both names here.)                     

Team:

Roundtable teacher:

Select any of the following options that apply:

I would like an appointment tomorrow.
I MUST have an appointment today. My situation is an emergency.
I would like an appointment within the next week.
I need only about 10 minutes of time to ask a question or share information.
If my counselor is not available, I would like to see someone else.
I have Band, Chorus, or Orchestra during E&R tomorrow.

E-mail address, if you'd like a response by e-mail: 

Please share anything you 'd like your counselor to know about why you'd like to meet. 

You don't have to share this information if you'd prefer not to.