Human Resources >
Enrollment Change form graphic

The District utilizes various forms pertaining to the healthcare benefits (medical, prescription, dental).  If you have a question regarding the Enrollment/Change forms, please contact Eileen Seichepine in the Human Resources Department at 610-892-3470 extension 1406 or at


IBC (medical) Enrollment/Change Form

United Concordia Dental Enrollment/Change Form    

Disenrollment from Healthcare Benefits Form