Instructions

Verify date of last physical with Nurse Fitzsimmons (or Nurse Payne at PVC). If the physical on file was completed with the past 12 months, Nurse Fitzsimmons or Payne will sign off on the form and a working permit can be issued to the student.  OR you can bring a copy of your physical to Mrs. Ratliff with the filled- out application if the physical was done within the past 12 months.

Fill out part I of the application.

Parent or guardian must sign Part I of  the application.

Student must bring completed application, signed by a parent or guardian and the school Nurse, back to the guidance office.

Upon receipt, Ms. Ratliff will fill out the working permit and student will sign the working permit.  (Parents cannot pick up working permits for their students, as they must be signed in front of the person issuing the certificate).

If the last physical on record at the school was done over 12 months ago, a Physical Fitness Certification form must be filled out by a physician prior to receiving the working permit. 

Please note:  There are laws regarding hours of employment for minors listed here and on the back of the permit.

If you live in the Croton-Harmon school district and do not attend Croton-Harmon schools, you must fill out part I as noted above and also bring in Evidence of Age (Birth Certificate, Passport, State Issued photo ID) as well as documentation of a physical done within 12 months.

Any questions can be directed to marlene.ratliff@chufsd.org or call the guidance office at 914-271-4791 X1210

Employment Certificate Application

General Information and Laws regarding the Employment of Minors