Holland Central School District

Junior/Senior High School Guidance Department

 

Working Papers and Child Model Permits

  • All students under the age of 18 are required by New York State to obtain working papers to legally work a part-time or full time job.

  • To obtain working papers, print out or pick up the forms in the Guidance Office. (AT-17 or AT-22 Application for Employment Certificate) (AT-16 Physical Fitness Certification)

  • Part 1 of the application needs to be completed with SSN and parental signature.
     
    ü If you DO NOT attend Holland Junior/Senior High School, you will need your birth certificate or picture ID for proof of age

  • The Physical Fitness form must be signed by the family physician certifiying that the student is healthy enough to work. If the student has had a sports or school physical within the year, our school nurse can verify the physical on the form.Complete top section on the physical fitness certification form and have:

ü Your physician or the school nurse complete Section A indicating that you have had a physical within the last 12 months.

Note: During summer months, Mrs. Thompson can complete the certification form if you have a school physical on file.

  • Students must return both forms to the Guidance Office for processing. When dropped off during homeroom they can be picked up at the end of the day or please allow 24 hours to process. The certificate must be signed by the student in the presence of school personnel.

  • Please refer to the General Information sheet included with the application for further information. For any questions, please call or e-mail Mrs. Thompson at 537-8215.

Related Files pdf

New York State Department of Education Working Papers
 
All students under the age of 18 are required to obtain working papers to legally work any job.
 
Type of working papers available:
  • Child Model Permit - must be renewed yearly
  • Student Non-Factory Employment - 14 - 15 year old
  • Student General Employment Certificate - 16-17 year old
  • Full-Time Employment - 16-17 year old no longer attending school
  • Newspaper Carrier Permit - 11 -18 year of
  • Farm Work - 14-15 year old
  • Special Farm Permit - 12-13 year old
An application and physical fitness certification form is available in the Guidance office.  Part 1 of the application needs to be completed with SSN and parental signature.  The Physical Fitness form must be signed by the family physician certifiying that the student is healthy enough to work.  If the student has had a sports or school physical within the year, our school nurse can verify the physical on the form.
 
Once the application and physical form is filled out, both need to be returned to the Guidance Office.  The working papers are prepared by Guidance office personnel and need to be signed by the student.  Once signed they are ready to be taken by the student.
 
The student is encouraged to keep the original and have their employer make a copy when they begin a job.