Request Support

Use the form below to request EMOTIONAL SUPPORT for a Freire Schools student. Requests may be submitted by the student themselves, or by a parent, guardian, family member, classmate, or friend on the student’s behalf.

Referral forms received outside of school hours are not seen until the following school day. If you or the person you are referring are experiencing an emergency, please contact 911, 988, or access crisis resources at this link.

Fields marked with an * are required.

Leave this field empty

Name of the student you are requesting support for *

Grade of student *

Describe what’s going on, in 1–2 sentences *

What Freire Schools campus does the student attend? * Please select… Freire High Freire Middle TECH Freire Freire Wilmington

Are you requesting on behalf of someone else? *

No, I’m a student requesting support for myself

Yes

Name of person completing form (optional)

Relation to the student you are referring (optional) Please select… Parent, guardian, or family member Classmate or friend Other

Email of person completing form (optional)

Submit Request