Revised
8/05
Work Permit
Instructions
(These
Instructions are for an ES to print to give to their
student.)
A completed Work Permit Packet must include
the following or it will be returned:
2.
3. A copy of the student’s Social Security Card with the same name as the one in which the work permit is requested.
4.
A copy of the student’s official Birth certificate.
Work Permit Application
Instructions:
To ensure prompt processing of your new
Work Permit Packet, please follow these instructions
carefully.
*
Print clearly and legibly.
*
Fill in ALL areas of the “Request for Work Permit” form
completely.
*
Under “For Employer to Complete” your employer must provide sufficient
detail under “Minor’s Work Duties” i.e. description of job responsibilities,
tasks, duties to be performed by the student, etc. For any unspecified work duty
descriptions, the form will be returned to the student so that the employer can
supply specific detail. Failure to
provide specific detail will delay the process in obtaining your work
permit.
*
If you are applying for an additional job, please indicate
“2nd Job” on the upper left hand corner of the “Request for Work
Permit” form.
*
Date and Signature of Parent or Guardian
*
Include copy of Social Security Card
*
Copy of certified Birth Certificate
*
Signed/Dated “Statement of Intent to Employ Minor and
Request
for Work Permit” form.
*
Specific Job Duties Description
*
Maximum number of hours that the minor will be
working.
For Processing of the Work Permit Paperwork by school:
CWCS:SEND
COMPLETED WORK PERMIT PACKET
TO:
ATTN: Work Permits
12420 Bentley Street
(800) 808-9895, Ext. 6
Fax: (209) 874-9531
OGCS and SSCS: Fax
or mail COMPLETED WORK PERMIT PACKET
to:
ATTN: Work Permits
1166 Broadway,