School / College Counseling                  Basic Plan                                                                                             Consent & Engagement Form


Basic Counseling Plan (4 hours/week – yearly)

Annual Youth Development Exam & Membership Program

We confirm that we have read and understood the Informed Consent & Service Agreement and agree to engage in the services voluntarily.

We understand that counseling services are provided on a yearly basis and that payments made are non-refundable except where required by applicable law.

We confirm that the institution will obtain necessary parental or guardian consent for students wherever required.

We agree to receive official service-related communication via email or phone.

School / College Counseling Basic Plan Consent & Engagement Form

Institution Name

Type of Institution

Address of Institution

Contact Email (Institution)

Contact Phone Number