* 1. Email address *

* 2. Student Grade: *

* 3. I know who my child's school counselor is.

* 4. I know how to contact my child's school counselor.

* 5. I meet with my student's school counselor at least once a year. Either one on one or at a school meeting. 

* 6. Choose up to FIVE topics that you feel are most important for the students:

* 7. The school counselor and other resources/organizations are available to facilitate several small groups throughout the school year. If you would like your student to be part of a small group, please include his or her name and the topic(s) of interest below. *A minimum number of students required to make a group

Grief
Social Skills
Self Harm
Bullying 
Divorce 
Self Esteem
Anger Management
Other

* 8. As I parent, I would like to attend a Parent Workshop on the following topic(s):

* 9. What comments or suggestions do you have for the school counselor?

* 10. If your student is a senior and you would like to be added to the scholarship information email group, please enter your email address below:

* 11. If you have any special concerns regarding your student, please feel free to contact the school counselor by email at kelly_richards@ecboe.org.

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