Forms
Click any of the form titles below to download a PDF.
- New Student Registration
- Athletic Forms
- Community Forms
- Health Forms
- Technology Forms
- Student/Parent Forms
- PSSA/Keystone Testing Information for Parents & Guardians
New Student Registration
| Health History Form | This form details the health history of the student. |
| Home Language Survey | Title VI requires that school districts/charter schools identify limited English proficient (LEP) students. |
| Northern Lebanon Information Form | This form contains all student information for the Norleb School District |
| Parental Registration Statement - English | Pennsylvania Act 26 of 1995 requires all parents, guardians, or others to produce a notarized affidavit when transferring their children to a new school. |
| Request for Records 17-18 | This form is a request for student records. |
| Residency Affidavit 17-18 | This affidavit is only required if you live with another family in the district. |
Athletic Forms
| PIAA Pre-Participation Physical Form | This physical form needs to be completed before participating in any sport. |
| Code of Responsibilities Agreement | This form needs to signed in order to participate in a co-curricular or extra-curricular activity. |
Community Forms
| Use of District Facilities Application | Complete this form if you are interested in using any district building or space for an event. |
| Program Volunteer Affidavit | Must be filled out and include the documentation mentioned in order to help as a volunteer for the Northern Lebanon School District. |
| Right to Know Request Form | This form needs to be completed in order to request any school information to be released under the Right to Know Law. |
| Request to Address School Board Form | Complete this form in advance of a school board meeting to be allowed time to speak at the meeting. |
Health Forms
| Student Accident Insurance Brochure | This brochure details voluntary student accident insurance available from A-G Administrators. |
| Student Physical Exam Form | Pennsylvania Department of Health physical form for school students. |
| Student Dental Exam Form | Form to completed in order to provide record of a student's dental exam. |
| Student Medication Form | Request form for student to receive medication during the school day. |
Technology Forms
| Device Incident Report | This form is for when a district device is damaged, lost, or stolen and should be submitted to the technology department. |
| Parent-Student Agreement | This form is to be completed by parents and students at the beginning of each school year when devices are issued. Revised July 2018. |
| Student Device Handbook | This is the handbook for all students describing the rules and procedures while using district devices and working on the network. - Revised, July 2018. |
| Student Device Insurance | This form should be completed by parents and submitted within the first few weeks of the school year. |
| Summer Device Take Home Form | This form is for students in grades 6-11 who wish to take their Chromebooks home over the summer. Bring to Scheduled Device Collection Date/Time. Click to learn more. |
Student/Parent Forms
Submit for pre-planned school absences for
| Free and Reduced Lunch Application Spanish Free and Reduced Lunch Application | Complete and submit this form in order to apply for free or reduced lunch status for a student. |
| CTC Application | Form to be completed for a student to apply to attend or continue to attend the Lebanon County Career and Technology Center. |
| Address Change Request | Complete this form if a student is changing their home address. |
| High School Excused Trip Form | Form for excused pre-planned educational trip or medical absence - High School students. |
| Middle School Excused Trip Form | Form for excused pre-planned educational trip or medical absence - Middle School students. |
| Elementary Excused Trip Form | Form for excused pre-planned educational trip or medical absence - Elementary students |
| Elementary Daily Excuse Absences | Use for Daily Absences for elementary students - submit to main office. |
| Graduate Transcript Request | For a graduated former student to request a transcript. |
| Graduation Project Log | Used to log graduation project hours. |
| Homecoming/Prom Guest Form | Must be completed prior to purchasing a ticket if you are bringing a guest from another school. |
| Student Transcript Request | For current students requesting a transcript. |
| Parent Release of Info Form | Complete this form to allow the school to release educational information of your student. |
| Parking Permit Application | Form for high school students to complete to apply for a parking permit. |
| Request for Attendance Exception Due to Child Care | Complete this form to apply for an attendance exception due to child care. |
| Student Assistance Team Referral | Students should fill out this form in order to refer another student to the Student Assistance Team. |
PSSA/Keystone Testing Information for Parents & Guardians
| Electronic Device Information for PSSA and Keystone Testing | PDE rules regarding use of cell phones, smartphones and other electronic devices during testing. |
| PSSA Information for Parents and Guardians | Answers to frequently asked questions regarding PSSA testing. |
| Pennsylvania Calculator Policy | PDE rules regarding calculator use during testing. |
| PSSA Code of Conduct For Test Takers | PDE do's and don'ts for students taking PSSA. |
| Parental Information for PSSA Opt-out | Protocol for parental request for exclusion from the PSSA assessment. |