Forms - Northern Lebanon School District

Athletic Forms

Community Forms

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 (English) https://www.1stagency.com/	Details voluntary student accident insurance available from A-G Administrators.
Student Accident Insurance (Spanish)
Student Physical Exam Form (English)	Pennsylvania Department of Health physical form for school students.
Student Physical Exam Form (Spanish)
Student Dental Exam Form	Form to completed in order to provide record of a student's dental exam.
Student Medication Form (English)	Request form for student to receive medication during the school day. Request form for student to receive medication during the school day.
Student Medication Form (Spanish)

Technology Forms

Parent-Student Agreement

This form is to be completed by parents and students at the beginning of each school year when devices are issued.

Student Device Handbook (English)

Student Device Handbook (Spanish)

This is the handbook for all students describing the rules and procedures while using district devices and working on the network.

Student/Parent Forms

Residency Affidavit
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 (English)	Complete this form if a student is changing their home address.
Address Change Request (Spanish)
Secondary Excused Trip Form (English)	Form for excused pre-planned educational trip or medical absence - High School/Middle School students.
Secondary Excused Trip Form (Spanish)
Elementary Excused Trip Form (English)	Form for excused pre-planned educational trip or medical absence - Elementary students
Elementary Excused Trip Form (Spanish)
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.
High School Dance Guest Form	Must be completed prior to purchasing a ticket if you are bringing a guest from another school.
Student Transcript Request (English)	For current students requesting a transcript.
Student Transcript Request (Spanish)	For current students requesting a transcript.
Parent Release of Info Form (English)	Complete this form to allow the school to release educational information of your student.
Parent Release of Info Form Spanish)
Application for Work Permit	Complete this form to request a work permit for 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 (English)	Complete this form to apply for an attendance exception due to child care.
Request for Attendance Exception Due to Child Care (Spanish)
Student Assistance Team Referral	Students should fill out this form in order to refer another student to the Student Assistance Team.
Elementary Student Handbook (English)	Current/New policies and procedures for elementary schools.
Elementary Student Handbook (Spanish)	Current/New policies and procedures for elementary schools.
Secondary Student Handbook (English)	Current/New policies and procedures for the secondary schools.