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Work Permit Request
Hi Students! If you are requesting/renewing a Work Permit please complete the following questions. Please email your counselor if you have any questions.
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* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
6 Digit Student ID #
*
Your answer
School Email
*
Your answer
Grade
*
9th
10th
11th
12th
Work Permit Status?
*
Renewing a Work Permit
Requesting a New Work Permit
Other:
Required
Employer -Name, Address, Name of Manager, Employer's Phone Number (Example: Taco Bell, 12156 South St, Artesia, CA 90701, John Smith, (555)555-5555).
*
Your answer
A copy of your responses will be emailed to the address you provided.
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