Welcome to the Lincoln Public Schools forms page. These are the official forms for LPS staff. Search by name, department, or form number.
Search
Application for tuition credit points for teachers who assist student teachers, 10/pack, 2-part NCR
Application for Professional Enhancement Fund, to request reimbursement for professional activities in exchange for points earned for working with student teachers. 15/pkg, 2-part NCR
These are optional notes regarding Professional Enhancement Fund usage. If there were any notes associated with this form, they would appear here.
Hourly time report, individual
Acknowledgement of the responsibility of managing a location or department's procurement cards
To summarize payroll for a pay period
Audit log of armored car pick ups
A record of bus passes sold
To process financial claims
To accept responsibility for a location or department's procurement card transactions
Paperwork to request W-2 forms for the current or past years pay
To accept responsibility for a location or department's procurement card transactions
Application for financial assistance for students involved in athletics or other activities
This form is required for participation in high school athletics and many activities.
The form lists rules from the Nebraska Schools Activities Association for interscholastic competition, Lincoln Public School rules, and Due Process for Extracurricular Activities. Parents will complete and sign appropriate eligibility information and consent to participate. Students are required to sign the application for participation. Forms are submitted to the high school where the student will attend an wishes to participate.
This form is to be used to purchase and assign apps for Apple iOS devices only. The attached form includes a website for you to access to determine pricing for each app.
To transfer materials from one building to another
For use when items must be returned to the Distribution Center or vendors
The Facility Use Application Form has been retired. All facility requests must now be submitted using the LPS Archibus system. Please click on the Facility Use Form link above to access the system.
Health information to assist staff in responding to students' health needs
The legal requirements for physical examinations and immunization
State requirements for student immunizations
Log of students seen and actions taken
Notification when student is injured or ill, and parent is not available by telephone
Letter to parents requesting additional information from medical provider for participation in physical education and sports
Parental request for school nurse to administer student medication
State statutes regarding physical examinations and form for physician to complete
This form is also available through the Distribution Center (#526009)
Information to be given to nurse by parents about child's medical condition
To object to the legally required physical exam prior to beginner grade and seventh grade.
Information supplied by parent or guardian to assist in student diabetes management
Management plan for student severe allergies
Information for school nurse about a child's seizures
Statement of medical or religious objections to immunizations required by the state
Information requested of parents to update school health records
Form to be completed when parent/guardian requests specialized procedures to be done by non-district personnel during the school day
Request and consent for school nurse to perform specialized procedure
Confirmation that child has had chicken pox
Checklist for evaluation of a head injury
Evaluation form required by state law when a child enters school.
*
Agreement for students , parents and medical persons to sign
*
Parent, student and physician agreement
Form for parents to protest the state-required vision evaluation for children entering school.
To record medical professional's recommendation for children with Down Syndrome.
*
The official name of this form is: Request to Provide Medication During School Hours: Acetaminophen and Ibuprofen
*
*
This form is also available from DC under the form number 526039
TDAP Notification Letter
Hepatitis B Interval Letter
Fee waiver application for elementary and secondary student activities.
Dietary requirements for individual students
This agreement/invoice is to be used when schools or departments are making an agreement with an individual or company for services that cost more than $600.00.
This form functions both as a contract and an invoice, and is appropriate for contracts $600.00 or less.
Special Item Requisition Form for staff
To report employee injuries or occupational diseases
Employee's record of declining treatment for a work-related injury
Physician's recommendations for return to work for Workers' Compensation
Supervisor's agreement with injured employee about restrictions
Recording mileage for trips necessary as a result of work-related injury
To report exposure with blood or other potentially infectious material
*
For staff to decline treatment after a bloodborne exposure incident.
*
Option for Hepatitis B Vaccination
Doctor's documentation for employee return to work - mental health issues
To be completed by treating physician prior to returning to work
*
Agreement between parent and administrator for the loan of equipment
Invoice for services provided to students and/or parents
Verification for Special Needs students of graduation demonstration fulfillment
Dated agreement for home use of equipment
Parental or guardian permission to release non-directory information about students under 18 years of age. Individuals 18 years of age or over may have information released upon the authorization of their own signature.
To indicate preference of student surname other than that recorded on birth certificate
Information about Section 504 rights
Definitions, instructional, health and behavioral accommodations checklists
Parent request to exclude their child's information to others
Communication with parents regarding Americans with Disabilities Act
The Incident Referral to Administrator form is available to staff to use for a violation of school rules by a student. This form should be used when the staff member would not be able to use the online Synergy Incident Referral.
Request for student to receive transportation services who presently does not
No forms match your search criteria.