Attached is the full work permit application. You need to print all 4 pages, then read and complete the information. Once you have all the information completed, including the employer and parent signature, email the four pages to Janet Blackketter at firstname.lastname@example.org when school is in session or to Ashley Fisher at email@example.com during the summer. Then, a work permit will be issued via email and scanned documents.
When completing the work permit application, please use the following directions.
• Student, parent/guardian and employer should read the document prior to signing.
• ALL information must be completed in INK.
• Student completes the top part of the page. Be sure to list the name of the Employer (COMPANY NAME), the name of your direct supervisor, the address of the EMPLOYER, and the phone number of the EMPLOYER.
• Employer needs to complete ALL information in the box. Work permits cannot be issued unless all the information is completed. The NAME of the employer's Workers' Compensation provider is required, but not the policy number.
• Student, parent and employer must sign the bottom of this page.
• Student completes the top part under "Minor's Information". ALL information must be provided, including home phone (or parent's cell number) and Social Security Number.
• Parent/Guardian must print name and sign under "To be filled in and signed by parent or legal guardian".
• Employer must complete ALL information under "to be filled in and signed by employer".
• RBHS will complete the bottom section when you bring in the application to your appointment.
• Information only, but should be reviewed by student, parent and employer.