Intermediate School Forms

The following forms are now filled out using Final Forms.  Click here to fill them out.


 New Student Registration Process
 Contact Information
 Demographic Information
 Additional New Student Info
 Health History & Medical Profile
 Injuries & Hospitalizations
 Past & Ongoing Health Conditions
 Emergency Medical Authorization
 Remote Learning Information
 Student Media Release
 Acceptable Use Policy
 Student Handbook


The following forms you can print and turn in if needed:


Free & Reduced Lunch Form
Chippewa Local School District offers the free/reduced national school lunch program.  Those of you who were on the program last year will remain on the program and have until October 1st to complete and send in a new application for this year.  

All may apply for the free/reduced lunch program.  The application is family based, so there is no need to fill out multiple forms for siblings.  They can all be listed on the same form.  Forms can be obtained online & at any school building.

To see if your household qualifies for free or reduced lunches, please print, complete & return application to appropriate building for approval.   You may also send completed application to:

Chippewa Local Schools Food Service
56 North Portage Street
Doylestown, Ohio 44230

You may apply to the free and reduced lunch program at any time during the school year and reapply as needed if you experience changes to your income.

Free & reduced information will remain confidential.


Medication Request Form
Please fill out thIs form if your child needs medication at school.  We must have this form on file if your child needs to take medication during the school day or needs to keep any kind of medication with them (ex. epi pen, inhaler)


Notice of Parents Right-to-Know
You have the right to know about the teaching qualifications of your child’s classroom teacher in a school receiving Title I funds.  Click above for more information.