The Commonwealth of Massachusetts
Division of Occupational Safety
19 Staniford Street, 2nd Floor
Boston, MA 02114
Employment Permit Application for 14 through 17 Year-Olds
If you are under 18 years of age, you must obtain a work permit before starting a new job.1 M.G.L. c. 149, §§86-89. The following are the steps you should take; please note that a Physicians Certificate of Health is required only of 14 and 15 year-olds. Steps for Getting an Employment Permit
1. Obtain a job offer from an employer.
2. Ask the employer to complete the following section:
Promise of Employment
Name of Minor:
Name of Employer:
Job Title & Primary Duties:
Number of Hours per day Minor is to be Employed:
The undersigned agrees to employ this minor as stated above and in compliance with state law. A summary of laws governing minors’ hours of work and hazardous occupations can be found at the end of this application form.
Signature of Employer or Authorized Agent
3. For 14 and 15 year-olds only (16 and 17 year-olds may skip this step): Ask your doctor to complete the following section:
Note: The following Certificate of Health must be signed within 12 months of the date this application is presented to the school official issuing the permit. 1
Minors who are 17 years of age, who can show documented proof of a high school diploma or the equivalent to the school official authorized to issue work permits, do not need a signed work permit, but must still complete this permit application.
Physician’s Certificate of Health
I hereby certify that I have made a thorough physical examination of the following named 14 or 15 year-old minor:
______________________________________________________________________ and that, in my opinion, said minor is in sufficiently sound health and physically able to perform the work indicated above. A summary of laws governing minors’ hours of work and hazardous occupations can be found at the end of this application form. __________________________________________
Signature of Physician
4. Ask your parent, guardian, or custodian to sign below.
I hereby approve the issuance of a permit for the work indicated above. A summary of laws governing minors’ hours of work and hazardous occupations can be found at the end of this application form.
Name of Parent, Guardian, or Custodian
Signature of Parent, Guardian, or Custodian
5. Sign this application below:
Signature of Minor
6. Take this completed form to the Superintendent of Schools, or the person your school has authorized to issue Work Permits, in the school district where you live or in town where you attend school. You should bring with you proof of your age, such as your birth certificate, passport, or immigration record. The Superintendent, or his or her authorized agent, will then issue you an Employment Permit.
7. Bring the signed employment permit back to your employer who must keep it until you leave the job.
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Summary of Massachusetts2 Laws Regulating Minors’ Work Hours and Occupation Restrictions
Prohibited Jobs (Hazardous Orders)
Persons under 14 may not work: There are a few exceptions to this such as working as news carriers, on farms, and in entertainment (with a special permit). Persons under 16 years old may NOT:
• Operate power-driven machinery (except office machines or machines in retail or food service not otherwise prohibited)
• Cook (except on electric or gas grills that do not have open flames) • Operate fryolators, rotisseries, NEICO broilers, or pressure cookers • Operate, clean or repair power-driven food slicers, grinders or choppers • Perform any baking activities
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