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Forms

Click any of the form titles below to download a PDF.


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 FormThis physical form needs to be completed before participating in any sport.
Code of Responsibilities AgreementThis 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 AffidavitMust 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 FormThis 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 FormComplete this form in advance of a school board meeting to be allowed time to speak at the meeting.

Health Forms

Student Accident Insurance BrochureThis brochure details voluntary student accident insurance available from A-G Administrators.
Student Physical Exam FormPennsylvania Department of Health physical form for school students.
Student Dental Exam FormForm to completed in order to provide record of a student's dental exam.
Student Medication FormRequest 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 AgreementThis 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 HandbookThis 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 InsuranceThis form should be completed by parents and submitted within the first few weeks of the school year.
Summer Device Take Home FormThis 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 ApplicationForm to be completed for a student to apply to attend or continue to attend the Lebanon County Career and Technology Center.
Address Change RequestComplete 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 RequestFor a graduated former student to request a transcript.
Graduation Project LogUsed to log graduation project hours.
Homecoming/Prom Guest FormMust be completed prior to purchasing a ticket if you are bringing a guest from another school.
Student Transcript RequestFor current students requesting a transcript.
Parent Release of Info FormComplete this form to allow the school to release educational information of your student.
Parking Permit ApplicationForm for high school students to complete to apply for a parking permit.
Request for Attendance Exception Due to Child CareComplete this form to apply for an attendance exception due to child care.
Student Assistance Team ReferralStudents 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 GuardiansAnswers 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.
Keystones Exam Information for Parents and GuardiansBasic Information for Parents or Guardians about taking the Keystones Exams