Working Papers
Obtaining Working Papers - Students ages 14 - 17
Please complete the digital forms below and email back the following to Mrs. Keller, in the Guidance Office - lkeller@pvcsd.org. A work permit cannot be given without all the required documentation.
Form AT-17 (Application For Employment Certificate)
Complete Form AT-17 (Application For Employment Certificate)
Fill out PART I of this form, and have your parent or guardian sign it.
Obtain proof of age, such as your birth certificate, a state-issued photo ID, driver's license, or passport and email a copy with the application.
Physical Exam within the last 12 months. If your physical is over 12 months, please have your physician complete Form AT-16 (Physical Fitness Certification).
Form AT-16 (Physical Fitness Certification)
If you do not have a current physical on file in the nurse's office, Form AT-16 needs to be completed and taken to your physician for a signature and stamp.
Fill out the top two lines of the Physical Fitness Certification.
Your physician or the school’s nurse (when school is open) is qualified to fill out Part A or Part B of this form.
You will need to have had a doctor's exam within the last 12 months, saying you are physically fit.
Please send all the completed documentation as a single PDF. You can scan everything in the library. If you have a smartphone you can scan these documents into a single PDF and email them to Mrs. Keller. See the directions below.
After all the necessary paperwork has been received, your working papers can be issued and mailed to your home address. If you have any questions, please send Mrs. Keller an email or call 845-526-7810 x1304.
Remember, a work permit cannot be given without the above documentation!