Klein Oak High School

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Counselor Request - Ms. Gregory

Please fill in the blanks below to request information or a meeting with Ms. Hopkins.

Student Name

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Student ID #

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Grade Level

		9th
		10th
		11th
		12th

Reason

Please explain the what your concerns are, what you want to meet about, what information you need, etc.

1st Period Teacher & Room Number

Please enter the name of your first period teacher and the room number of your 1st period classroom.

2nd Period Teacher & Room Number

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3rd Period Teacher & Room Number

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4th Period Teacher & Room Number

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5th Period Teacher & Room Number

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6th Period Teacher & Room Number

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7th Period Teacher & Room Number

Please enter the name of your teacher and the room number of your classroom.

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