NSCC Counseling Services Interest Form

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Thank you for your interest in potential services/activities from NSCC Counseling Services. Please complete the short form below (takes < 2 minutes) and we will send you an email with an option for an appointment and/or link to join upcoming events of your choice. For questions, please contact Donna Davis at ddavis@northshore.edu or 978-762-4245.

First Name: *

Last Name: *

Preferred Name, if any:

Street Address (if employee, type NSCC): *

City: *

State: *

NSCC Email: *

Phone Number: *

I am *

Currently enrolled in CREDIT courses this semester at NSCC

Currently enrolled in NON-credit courses this semester at NSCC

NSCC Faculty or Staff

NSCC Alumni

Other:

I am interested in:

Friday Meditation Session from 12-1230pm

Individual Counseling Session (current students only)

Other:

Comments (include best days/times for meeting, if limited schedule):

In Case of Emergency Contact Name & Phone: *

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