Work Permits For Webster Schroeder Students
Schroeder Students
All forms are available below under Downloads.1. Application For Employment Certificate (AT-17)
- Complete Part 1 only
- Parent/guardian signature needed
- Must use legal name
- Complete in blue or black pen only.
2. Physical Fitness Certificate (AT-16)
Students must have had a Physical Exam in the last 12 months.
- Physician can sign the form.
OR
- Provide a copy of the Required NYS School Health Examination Form (not Health Summary) to the school health office to complete the form.
If the student is NOT enrolled in the building, provide verification of age with a copy of a birth certificate, driver's license or passport.
If you need a full-time work permit, you must show proof of graduation or that you have withdrawn from school.
Documents can be emailed to Cathy DeMocker at catherine_democker@webstercsd.org or dropped off with contact information at Schroeder High School.
The student must be available to pick up the work permit in person, Monday through Friday 8:00am - 4:00pm during regular school hours and 7:30am-2:30pm during summer hours.
