Booking of ECG Counselling Sessions for NorthLight School

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Please fill in this form to make an appointment with the ECG Counsellor.
For self-referred cases, students can fill up and submit this form personally.
For referred cases, teachers to fill up and submit the form with students' particulars.

1. Source of Referral

Referred by *

Form / Co-Form Teacher

Key Personnel

School Counsellor

School Leader

Student (Myself)

Subject Teacher

Other:

2. Student Information

Name of student *

Gender *

Female

Male

Level *

Year 1

Year 2

Year 3

Year 4

Graduated Students / Alumni

Class *

Email Address (Please provide a valid email address as the confirmed date, time and venue of this session will be sent via this email address) *

Mobile Number

Counselling Session *

This is my 1st session with the ECG Counsellor.

This is a follow-up session with the ECG Counsellor.

Area(s) for discussion with ECG Counsellor (You may choose more than one option) *

Career pathways/ opportunities/ information

Educational pathways

Interview / resume writing skills

Other:

Required

Preferred date for counselling (Please note that sessions are only held on Tuesdays & Thursdays) *

Preferred time slot for counselling session *

Recess Time

Lunch Time

3.00pm

3.30pm

4.00pm

4.30pm

Other:

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