Forms and Resources

CHIP Insurance

CHIP covers uninsured children and teens up to age 19 – and no family earns too much to qualify. With nearly 128,000 uninsured children in Pennsylvania, this is great news for families!

CHIP provides quality, comprehensive health insurance for routine doctor’s visits, prescriptions, dental, eye care, eyeglasses, mental health, and much more. CHIP covers uninsured kids who are not eligible for Medical Assistance. For many families, CHIP is free – for others, it is low cost.

CHIP School Flyer - English CHIP School Flyer - Spanish

Counseling Services

District Pest Management Letter

Do Not Photograph/Do Not Interview/Do Not Video Tape Form

Please print and complete this form if you DO NOT want your child to be Photographed, Interviewed or their Honor Roll/Achievement status published in any of our District Publications. Examples include but not limited to: In-Carlynton/Montour Magazine, Facebook, Twitter, District Website, etc.

Do Not Photograph/Do Not Interview/Do Not Video Tape Form

Speak another language? See the Do Not Photograph/Do Not Interview/Do Not Video Tape Form in your language by clicking on your language below.

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Educational Trip Request Form

The Carlynton Board of Directors and district staff believe that it is extremely important for students to be present for class daily to gain the greatest academic benefit from the learning process.

The District recognizes that family circumstances may require a student to be absent from school for what is termed a non-school-sponsored educational trip. In order for such an absence to be considered excused, this request form must be submitted to the Building Principal ten days prior to the trip.

Educational Trip Request Form

Excused Absence From School Form

The Carlynton Board of Directors and district staff believe that it is extremely important for students to be present for class daily to gain the greatest academic benefit from the learning process.

All students of compulsory school age are required to comply with the adopted Board policy governing attendance. When a student is absent from school, the parent/guardian must provide a written excuse to the Attendance Office at the JSHS or the Main Office at the Elementary level within three days of the absence when returning to school regardless of the student’s age. The parent/guardian may use this form to communicate the reason for the absence from school. This form may be downloaded and sent electronically through email to the building principal from a parent/guardian email account that is on file with the district. For College Visits and Educational Trips please submit the Educational Trip Request Form.

Excused Absence From School Form

Facility Request

Field Trip Permission Form

Fundraising Request Form

Please submit to the High School Administrative Office
Phone: 412-429-2500, ext. 1102
Email: kimberly.borza@carlynton.k12.pa.us

Requests must be submitted at least seven days prior to the start date of the fundraiser. NOTE: Consider all requests approved unless otherwise notified within five days of submission. (The sole purpose of this Fundraiser Request Form is to register all fundraisers conducted throughout the District during a calendar school year and prevent the overlap of fundraisers within the same time period).

Fundraising Request Form

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In This Section

Forms

Academic Calendar

Athletic Forms

CHIP Insurance

Counseling Services

District Pest Management Letter

Do Not Photograph/Do Not Interview/Do Not Video Tape Form

Educational Trip Request Form

Excused Absence From School Form

Facility Request

Field Trip Permission Form

Fundraising Request Form

Health Services

Volunteering

Voluntary Student Accident Insurance

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Links & Resources