ALL LBUSD FORMS

Insurance Forms

• LBUSD Claim Form
• Request for Certificate of Insurance ASCIP-B

*All LBUSD employee forms have been moved to the LBUSD All-Staff class in PowerSchool and will soon be removed from the website.

Business Office Forms

• Expense Reimbursement Statement
• Travel/Conference Request Form 2019

Employee Reimbursement Form

• 2019 Mileage Reimbursement
• 2019 Travel Expense Statement
• Pre-Approval Purchase Request Form

Payroll Forms

• California DE-4 State Withholding Form
• Direct Deposit Authorization Form
• Employee Benefits Election Agreement
• How to Read Your Online Pay Stub
• IRS W-4 Form (Employee's Withholding Allowance Certificate)

Insurance Form

• LBUSD Claim Form

Human Resources Forms

• Request for Leave of Absence
• Resignation Form
• Workers' Compensation Forms

BYOD Forms

• BYOD Chromebook Loaner Agreement
• BYOD LBHS Checkout Policy
• BYOD Mobile Device Agreement 

Complaint Forms

• Complaints Concerning Employees
• Complaints Concerning Instructional Materials
• Complaints Concerning Williams Legislation
• Complaints Concerning Pupil Fees (AB1575)
• Uniform Complaints Concerning Discrimination/Harassment  or District Programs
• Website Complaint Form

New Student Forms

• Kindergarten and TK Parent Questionnaire
• Kindergarten and TK Parent Questionnaire (Spanish)
• Kindergarten ONLY - Development Profile
• Ready for Kindergarten
• Ready for Kindergarten (Spanish)
• McKinney-Vento
• McKinney-Vento (Spanish)
• Record of Prior Special Programs
• Record of Prior Special Programs (Spanish)
• Residency Declaration Form - NEW STUDENT
• Residency Declaration Form (Spanish)
• Student Technology Use Agreement E 6163.4
• Student Technology Use Agreement E 6163.4 (Spanish)

• Authorized Health Care Provider Request for Nebulizer Treatment
• Concussion Guidelines - Parent Information and Forms
• Doctor Excusal from Physical Education Form
• Health Requirements for School
• Healthcare Resources for Parents
• Mandatory Tdap Verification Form for Incoming 7th Graders
• Oral Health Assessment Plan
• Parent/Guardian and Authorized Health Care Provider Request for Medication (English)
• Parent/Guardian and Authorized Health Care Provider Request for Medication (Spanish)
• Parent Home and Hospital Instruction Manual
• Physician Clearance to Return to School
• Report of Health Examination for School Entry (English)
• Report of Health Examination for School Entry (Spanish)
• Request for Certificate of Insurance ASCIP-B
• Student Accident Insurance Parent Brochure (English)
• Student Accident Insurance Parent Brochure (Spanish)
• Student Insurance Claim Form (English)
• Student Insurance Claim Form (Spanish)
• Student Incident Report Form
• Student Injury Claim FAQ
• Student Injury Claim Form

School Readiness Program

• Learning Link Registration Packet
• School Readiness Participant Authorization
• School Readiness Referral Packet
• School Readiness Referral Form

Transportation Forms

• On-line Bus Application
• District Paid Bus Application (2018-19)