Work Permit ES Approval/Denial

ES Name:
Student Name:			Grade:
School:	Connecting Waters Charter School	Date Requested:

My student named above has requested a work permit. My “X” below indicated that the requirement has been met (Failure to obtain a check in all areas may result in denial of a work permit):

	Student’s grade point average is currently 2.0 or better
______ Student is not on Academic Probation
	Student has regular school attendance (no truancies this school year)
	Student has attempted and passed the CAHSEE

ES Concerns

Please list appropriate information below, which will substantiate this student’s ability to work and continue as a successful student (include any concerns about academic performances, CAHSEE, truancies and job placement):

ESes Notice

If there are any changes in this student’s GPA, school attendance, or work environment while they have a valid work permit, it is your responsibility to notify the school office immediately to determine if this work permit needs to be revoked.

ES Statement

Based on the above facts (mark “X” for one):

I recommend this student for a work permit for the requested job assignment.

I do not recommend this student for a work permit for the requested job assignment.