Holy Name of Jesus School Forms

Holy Name of Jesus Downloadable Forms Cell Phone Agreement We have updated our cell phone guidelines.  Please see page #37 of the Parent/Student Handbook.  Confirmation Service Hours Form This form is necessary to record all service hours to satisfy eighth grade Confirmation requirements. Take Your Child to Work Form - 2 part form Take Your Child to Work day form.  Please make sure these forms are filled out. Submit the Absence (top part) Form to the homeroom teacher the week prior to the date the child will be absent. Submit the Return (bottom part) Form to the homeroom teacher the day following the absence. Field Trip Permission Parental Permission and Waiver for Field Trip Physician Medication Order Form For students who require medication during school hours.  Please get this form signed by your physician.  We can not administer any medication unless we have this form on file. Vacation Form Please submit one form per child to the homeroom teacher at least 1 week prior to a Vacation or Trip.    Dental Exam Form This form should be submitted to the school prior to a student entering kindergarten, third and seventh grade.  The form is given to new students entering these grades and at the end of the second and sixth grade school year.  Department of Health Dental Exam Form Dental Exam Form Central Dauphin Health Requirements Letter   Pennsylvania School Health Law requirements for children entering school. Private Physician's Report of Physical Examination of a Pupil of School Age Form This form is required for all children entering kindergarten or HNJ school for the first time and also for sixth grade.

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Holy Name Of Jesus School
6190 Allentown Boulevard Harrisburg, PA 17112-2603
Office (717) 657-1704 Fax (717) 657-9135