Student Support Intake Form.
Thank you for reaching out. Durham Tech is committed to supporting our students in accessing the resources you need to stay well and be successful. Submit this intake form to share about the resources you or your family may need at this moment, and we will do our best to connect you with appropriate supports on campus and in the community.
After you submit this form, a member of our student support team will be following up by phone or email as soon as possible.
For immediate support in a crisis, please visit
Durham Tech's Counseling Services
page for information about getting help right away.
Name you go by (if different from above):
Durham Tech ID:
Don’t Have or Know participant ID Number
Please use your 7-digit Durham Tech Student ID number
Are you the parent/guardian to any biological, adopted, step, or foster children who live in your household?
Do you have safe, stable housing?
What type of resources are you looking for assistance in connecting with?
Financial assistance for rent, utilities, etc.
Financial assistance for tuition or school-related expenses
Computer or internet access
Mental health or counseling services
Support for anxiety and stress during COVID-19
COVID-19 vaccination information
None of the Above
If you feel comfortable, please share more about your current challenges and hopes.