Work Permit Instructions

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

When requesting a work permit application please email Brandi Jaquint: brandi.jaquint@middletownusd.org

~ please read the following directions ~

• 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 to

at brandi.jaquint@middletownusd.org , if you can not upload your permit please bring your permit to the Middletown High School office.

Brandi Jaquint will issue the work permit via email or you can make arrangements with her to pick it up.

If you have any questions please email : brandi.jaquint@middletownusd.org

** If you are currently employed and would like to work over the summer

please let Brandi Jaquint know so she may issue your summer work permit.