Forms
Click any of the form titles below to download a PDF.
- Athletic Forms
- Community Forms
- Health Forms
- Technology Forms
- Student/Parent Forms
- 2020-2021 PSSA/Keystone Testing Information for Parents and Guardians
- Free Reduced Lunch Forms
- COVID-19 Forms
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 | Details voluntary student accident insurance available from A-G Administrators. |
| Student Physical Exam Form (English) | Pennsylvania Department of Health physical form for school students. (English version) |
| 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. |
Pennsylvania Department of Health physical form for school students. (Spanish version)
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. 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. |
Student/Parent Forms
| 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. |
| Secondary Excused Trip Form |
Form for excused pre-planned educational trip or medical absence - High School/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. |
| Current/New policies and procedures for elementary schools. |
2020-2021 PSSA/Keystone Testing Information for Parents and Guardians
This is a building level testing schedule.
This is a building level testing schedule.
Keystone Testing Schedules - Spring 2021
o Literature - Sections 1 and 2 - 05/19/21 (7:30 - 11:30 AM)
o Algebra I - Sections 1 and 2 - 05/26/21 (7:30 - 11:30 AM)
o Biology - Sections 1 and 2 - 06/02/21 (7:30 - 11:30 AM)
Answers to frequently asked questions regarding PSSA testing.
PDE rules regarding calculator use during testing.
PDE do's and don'ts for students taking PSSA.
PDE rules regarding use of cell phones, smartphones and other electronic devices during testing.
· English Language - Section 1 and 2 - Grades 6, 7, 8 - Wednesday, 5/5/2021
· English Language - Section 3-Group A - Grades 6, 7, 8 - Thursday, 5/6/2021
· English Language - Section 3-Group B and full-time live stream and virtual students - Grades 6, 7, 8 - Friday, 5/7/2021
· Math - Section 1 and 2 - Grades 6, 7, 8 - Wednesday, 5/12/2021
· Science - Section 1 and 2-Group A - Grade 8 - Thursday, 5/13/2021
· Science - Section 1 and Section 2 - Group B and full-time live stream and virtual students - Grade 8 - Friday, 5/14/2021
· English Language - Grades 3-5 - Monday, 5/3/2021-Wednesday, 5/5/2021
· Math - Grades 3-5 - Thursday, 5/6/2021-Friday, 5/7/2021
· Science - Grade 4 - Monday, 5/10/2021-Tuesday, 5/11/2021
PSSA SPRING Testing Schedules - (SECONDARY Level)
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Gr. 6, 7 & 8 ELA - 05/05/21 - Sect. 1 (7:30 - 9:45) and Sect. 2 (12:15 - 2:30)
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Gr. 6, 7 & 8 ELA - 05/06/21 - Group A - Sect. 3 (7:30 - 9:45)
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Gr. 6, 7 & 8 ELA - 05/07/21 - Group B - Sect. 3 and full-time live stream and virtual students (7:30 - 9:45)
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Gr. 6, 7 & 8 Math - 05/12/21 - Sect. 1 (7:30 - 9:45) and Sect. 2 (12:15 - 2:30)
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Gr. 8 Science - 05/13/21 - Group A - Sect. 1 (7:30 - 9:45) and Sect. 2 (12:15 - 2:30)
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Gr. 8 Science - 05/14/21 - Group B - Sect. 1 and full-time live stream and virtual students (7:30 - 9:45) and Sect. 2 and full-time live stream and virtual students (12:15 - 2:30)