About our Working Permit Applications

  • Requirements for Applicants:

    Minors (under age 18) require employment certificates for most jobs. Minors must apply for an employment certificate or permit on the form prescribed by the Commissioner of Education. The Pine Valley Jr./Sr. High School Counseling Office will handle such applications.

    The applicant must be present when returning the application because the Employment Certificate must be signed in the presence of the issuing official.

    The applicant does not need to have a job, nor does the school need to know by whom the applicant is to be employed.

    Directions to Complete the Application:

    The following information is required in order to obtain the Employment Certificate.

    • Part I: Parental Consent - Fill in all dotted lines. Be sure to have a parent or guardian sign. 
    • Part II: Evidence of Age - Bring a copy of your birth certificate or your state ID.
    • Part III: Certificate of Physical Fitness - The student must have a physical examination from their doctor or school physician within 12 months of the application date. It is the responsibility of the child/parent to contact their physician to obtain this documentation. This documentation must clearly state the child is physically qualified for work. This documentation will be returned to the student.

    Next Steps:

    • Parts IV, V, VI are not required for most applicants. Please do not write in these sections.
    • Once the application is complete, please return it to Mrs. Chase in the PVHS Counseling Office.

    “The issuing school may revoke certificates and permits for appropriate causes. For example, a school may revoke a certificate or permit when employment interferes with required school attendance, or is affecting a minor’s progress in school. Also, certificates and permits can be revoked if school officials discover that issuance of the working papers was based on false information, or if employment is affecting the health and welfare of a minor in other ways. In such instances, after due notice, schools can revoke certificates and permits.”
    The Laws Governing the Employment of Minors can be obtained upon request at the PV Counseling Office. You can also find more information about the employment of minors below.
    If you would like to print the documents at home, click the link below. Otherwise, all documents can be obtained in the PV Counseling Office during regular school hours.
    Please call Mrs. Youngberg, our High School Counseling Office Secretary, if you have any questions- 988-3276 ext. 4334.

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