Work Permit

Work Permit

West Carrollton Middle School
Building Photo2013828111834352_image.gif
424 E. Main Street
West Carrollton, OH 45449
Phone: 937-859-5121 ext 7700
Fax: 937-859-2780

Work Permit

Click on the links below to view open a printer-friendly copy of the Application for Minor Work Permit and Physician's Approval form.

Work Permit Document.pdf


Please note the following:

  • Students are required to complete the “Student/Applicant Information” section. This section requires a parent/guardian signature.
  • The potential employer should completely fill in the “Pledge of Employer” section, including boxes 1-4.
  • The student is required to obtain a Physician’s physical, valid for one year. The “Physician’s Approval” portion of the application must be completed by the Physician who conducted the student’s exam.
  • Once all these are complete, the student will take the application to the High School office, located at 5833 Student Street in West Carrollton to complete the application.
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