Loyalsock Township School District

District Employee Forms

Employee Absence Report/Request Form

• Employee Absence Report/ Form

Employee Benefits / Human Resources

• Health Insurance Enrollment Form
• Delta Insurance Enrollment Form
• Vision Insurance Enrollment Form
• 2026 Health Savings Account Deduction Form
• Section 125 Election Form
• Life Insurance Enrollment Form
• Life Insurance Beneficiary Designation
• Unpaid Leave Benefit Expense Acknowledgement Form
• Employee Change Form
• Residency Certification Form
• AFLAC Change Form

Lancer Foundation Mini Grant On-line Application

• Mini-Grant Online Application

Miscellaneous Forms

• Loyalsock Township School District Grant Application
• Printable Loyalsock Township School District Grant Application

Payroll Forms

• Personal Data Form
• Residency Certification Form
• 403 (b) Salary Reduction Agreement
• Local Services Tax Exemption Form
• PSERS Qualification for New Employees
• Form W-4

Professional Development Forms

• Professional Growth Plan for Action Research Form
• Professional Growth Plan for Peer Coaching Form
• Professional Growth Plan for Portfolio Mode

Professional Growth Grant Procedures & Forms can be found under Accounts Payable Tab

Reimbursement forms

• Mileage Reimbursement Request
• CONFERENCE REIMBURSEMENT REQUEST

Time Sheets

• Hourly
• Salary