Application for Work Permit

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TO BE COMPLETED BY PARENT/GUARDIAN.
Once application has been accepted, an appointment will be made available to you and sent via email.
Parent/Guardian MUST ACCOMPANY minor to the appointment. The in-person appointment will occur at the High School Main Office. Our office hours starting 8/29/22 are Monday - Friday, from 8:00AM - 4:00PM. Instructions will be included in the appointment email to follow. Please allow 3-5 days for a response with your appointment date and time. *If your student already has a position and requires the permit prior to the scheduled appointment, please email sroam@nazarethasd.org and accommodations will be made.
**IF YOU HAVE ALREADY COMPLETED AN APPLICATION, BUT MISSED YOUR APPOINTMENT, PLEASE DO NOT COMPLETE ANOTHER APPLICATION, SIMPLY SEND AN EMAIL TO: sroam@nazarethasd.org AND YOUR APPOINTMENT WILL BE RESCHEDULED.

Email *

Date of Application *

YYYY

First Name (of Minor ) *

Middle Name (of Minor) *

Las Name (of Minor) *

Sex *

Female

Male

Color of Hair *

Color of Eyes *

Any Physical Work Restrictions *

Street Address *

City *

State *

Zip Code *

Place of Birth (Facility) *

City and State of Birth *

Date of Birth of Minor *

YYYY

Current Age of Minor *

Evidence of Age Accepted and filed. (Evidence is required at time of physical signature) *

Original Birth Certificate

Valid Passport

Valid Drivers License

Name of Parent/Legal Guardian *

Email Address of Parent/Legal Guardian *

Submit

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