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Please fill in the form below to open a new ticket.

Contact Information
Email Address
Full Name
Phone Number
Contact Times Please provide some times that would work best to reach you by phone
Help Topic
Request Services
Student Demographics
Please select the district where your student(s) attend classes
Please indicate the grades your student(s) will be entering this fall
My student(s) associate with the following Nebraska Tribe(s). (You may select any or all that apply)
Services Please fill out any of the below services. Please note, you do not need to select services from all categories.
Native language(s) course Would you be interested in Native language(s) being offered to your student(s) either during the school day or through an after-school program?
Other If you selected "Other" for Native Langues Courses, please fill that in here
Academic supports Do you believe your student would benefit from additional academic supports designed specifically to their individual needs?
Other If you selected "Other" for Academic Supports, please fill that in here
Financial assistance Would your student(s) benefit from financial assistance to increase involvement in any of the following? Select
Other If you selected "Other" for Financial Assistance, please fill that in here
Social/Emotional Supports Do you believe your student would benefit from additional social/emotional supports designed specifically to their individual needs? Select
Other If you selected "Other" for Social/Emotional Supports, please fill that in here
Cultural Opportunities Would your student(s) be interested in participating in cultural opportunities provided by the district through an after-school or club format? Select
Other If you selected "Other" for Cultural Opportunities, please fill that in here
What other offerings/activities/supports would you like to see from your district for your student(s)? Rich text editor
Parental involvement/Guidance
If you are willing to serve on a parent advisory council to guide this project, please check the box.
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Open a New Ticket

Contact Information

Student Demographics

Services

Parental involvement/Guidance

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