Please 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.
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