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Hazleton Area School District

Dedicated To Excellence In Education Through Student-Centered Learning

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    • CVS Benefit Summary Description 2019

      CVS Benefit Summary Description 2019

      CVS Benefit Summary Description 2019.pdf 461.28 KB (Last Modified on July 17, 2019)
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    • Davis Vision Enrollment/Change Form

      Davis Vision Enrollment/Change Form

      Davis Vision Enrollment Form 5 9 18.pdf 35.9 KB (Last Modified on July 17, 2019)
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    • Delta Dental Enrollment/Change Form

      Delta Dental Enrollment/Change Form

      Delta Enrollment-Change Form 5 9 18.pdf 15.88 KB (Last Modified on July 17, 2019)
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    • ESPA Grandfathered Staff Group Term Life Benefits

      ESPA Grandfathered Staff Group Term Life Benefits

      B7RJLife_C6_090319 ESPA GRANDFATHERED.pdf 290 KB (Last Modified on September 17, 2019)
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    • ESPA Group Term Life Benefits

      ESPA Group Term Life Benefits

      B7RJLife_C2_090319 ESPA.pdf 290.14 KB (Last Modified on September 17, 2019)
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    • HAEA PT Teachers Group Term Life Benefits

      HAEA PT Teachers Group Term Life Benefits

      B7RJLife_C5_090319 HAEA PT TEACHER.pdf 290 KB (Last Modified on September 17, 2019)
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    • Highmark Change Form

      Highmark Change Form

      Highmark Change Form 5 9 18.pdf 65.09 KB (Last Modified on July 17, 2019)
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    • Highmark Enrollment Form

      Highmark Enrollment Form

      Highmark Enrollment Form 5 9 18.pdf 75.01 KB (Last Modified on July 17, 2019)
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    • Long Term Absence Form

      Long Term Absence Form

      Longterm_Absence_Form_20180814.docx 29.25 KB (Last Modified on January 10, 2019)
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    • Mutual of Omaha Beneficiary Form

      Mutual of Omaha Beneficiary Form

      Mutual of Omaha Beneficiary Form.pdf 96.72 KB (Last Modified on July 17, 2019)
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    • PPO 500 SBC

      PPO 500 SBC

      PPO 500 SBC.docx 569.58 KB (Last Modified on July 17, 2019)
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    • PPO HSA 2000 SBC

      PPO HSA 2000 SBC

      PPO HSA 2000 SBC.docx 568.96 KB (Last Modified on July 17, 2019)
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    • PSERS Nomination of Beneficiary

      PSERS Nomination of Beneficiary

      psers_beneficiary.pdf 217.86 KB (Last Modified on January 28, 2015)
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    • Safety Inspection Checklist

      Safety Inspection Checklist

      safety_inspection.pdf 238.56 KB (Last Modified on January 28, 2015)
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    • Security Group Term Life Benefits

      Security Group Term Life Benefits

      B7RJLife_C4_090319 SECURITY.pdf 289.99 KB (Last Modified on September 17, 2019)
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    • Teamsters Group Term Life Benefits

      Teamsters Group Term Life Benefits

      B7RJLife_CertSum3_090319 TEAM.pdf 97.15 KB (Last Modified on September 17, 2019)
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    • US Imaging Welcome Letter

      US Imaging Welcome Letter

      Welcome_ Letter_US_Imaging.pdf 315.58 KB (Last Modified on January 28, 2015)
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    • WH 380 FMLA form for EMPLOYEE leave

      WH 380 FMLA form for EMPLOYEE leave

      WH-380-E.pdf 388.52 KB (Last Modified on September 1, 2020)
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    • WH 380 FMLA form for FAMILY MEMBER leave

      WH 380 FMLA form for FAMILY MEMBER leave

      WH-380-F.pdf 485.01 KB (Last Modified on September 1, 2020)
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    • Worker's Compensation Packet 2019-2020

      Worker's Compensation Packet 2019-2020

      WC_Packet_2019-2020.pdf 1.03 MB (Last Modified on July 10, 2019)
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    Having trouble viewing this site? Click the Email Us link above to let us know. The Hazleton Area School District does not discriminate on the basis of race, color, national origin, sex, disability or age in its programs or activities and provides equal access to all designated youth groups per the Boy Scouts Act. Inquiries regarding the non-discrimination policies may be directed to the Title IX Coordinator at (570) 459-3221 ext. 3444 or the Section 504 Coordinator at or (570) 459-3111 ext. 3156 at 1515 West 23rd Street, Hazle Township, PA 18202.
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