Example Of Employment Certificates

Here is an example of employment certificate that is usually issued.

_____ Employment During School Year

_____ Employment During School Vacations

This certificate authorizes the employment of __________________________________________(Name of Minor) ____________________________________ (Address of Minor)

Minor’s Age _____ Date of Birth _________________

Date of Issue _____________

Date of expiration _____________

Proof of age accepted ______________________________________ (specify proof of age)

Certificate of physical fitness accepted____________________

Grade Completed_____________ (Specify)

Place of Birth _____________________________________________

Color of Hair _______________ Color of Eyes ________________

Height _____ feet _____inches

Weight ______ pounds

Name of Parent(s) ___________________________________

Telephone Number ____________________________________

Signature of Minor ______________________________________

Issuing Office:

Issuing Officer's Signature______________________

Title________________________

Telephone Number__________________

Name of School__________________________________________________

Address of School_______________________________________________

City/State/Zip__________________________________________________

Certificate is valid for one year.

Note: Federal Hour Restrictions

• Not more than 3 Hours on a School Day
• Not more than 18 Hours in a School Week
• Not more than 8 Hours on a Nonschool Day
• Not more than 40 Hours in a Nonschool Week
• Not before 7 a.m. or after 7 p.m.

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