Click HERE for a Work Permit Request form

Be sure to follow the directions below for filling out your Work Permit Request

• Student, parent/guardian and employer should read the document prior to signing.

• All information must be completed in Blue or Black ink.

• Student completes the top part under "Minors Information".

• All information must be provided, including phone number, and Social Security Number.

• Parent/Guardian must print name and sign under parent or legal guardian section.

• Employer must complete ALL information under " to be filled out and signed by employer".

• Once permit is complete, please scan and email your work permit request to Tina Rockwell at tina.rockwell@middletownusd.org OR bring in to the high school office

Please allow 24-48 hours for your work permit to be finalized. It may be sent via email OR picked up in the office.

*** You must maintain a 2.0 GPA or higher to obtain and keep a work permit***

If you have any questions, please email tina.rockwell@middletownusd.org