Nevada Work Permit Application Form – Fill Out and Use This PDF

Department of Juvenile Justice Services

Juvenile Work Permit Application

To obtain a Work Permit the following requirements must be met:

Work Permits are required for juveniles 14 thru 17 years of age.

You must obtain a work permit every time you change your job until you reach the age of 18 yrs.

If not accompanied by your biological parent or legal guardian, you must have verifiable (i.e., copy of driver’s license) written permission from your parent or legal guardian (with legal proof of guardian) for every new application.

Foreign-born individuals must provide an Immigration Card, Naturalization Certificate or a U.S. Dept. of State Born Abroad Birth Certificate.

You must have a job or the promise of a job. (Work permit is issued to where you will work) You must provide any one of the following for legal proof age:

†Birth Certificate

† Current-Department of Motor Vehicle – I.D. Card, Driver’s License or Learner’s Permit Exp. Date: __________

†Current-Military I.D. Card Exp. Date: ________________

†Current-US Passport #: _____________________________ Exp. Date: _________________

†Current-Immigration Card #: ________________________________ Exp. Date: ___________________

†Baptismal Certificate

†School Transcript (No School I.D.’s permitted)

$1.00 fee for Work Permit.

PRINT ALL INFORMATION AND FILL OUT COMPLETELY

Please provide at window – DMV Parent Picture I.D. / Minor’s I.D. (No school I.D.’s) / $1.00 (correct denomination is appreciated)

Have you ever had a work permit in Nevada? Yes ____ No ____

Name: _________________________________________ Date of Birth: ________________ Age: ______

Address: _____________________________City: ___________ State: _____ Zip: _____ Tel: ___________

Place of Birth:___________________________________________ Sex: ______ Race: ________________

School:_________________________________________________ Grade:__________________________

Place of Employment:_______________________________________ Type of Job: ___________________

Location or Cross Streets: _________________________________________________________________

Work Hours – Start Time: ___________________________ Finish Time: __________________________

(Ages 16–17 if you don’t know the work hours, Parent please provide Latest Hour you will allow minor to work) Parents/Legal Guardian Name: ______________________________________________________________

I, ________________________________ Parent or Legal Guardian of ______________________________

Give him/her permission to work at __________________________________________________________

Date: __________ Signed by _______________________________________________ Verified I.D. _____

Circle who signed-photo I.D. required (Mother / Father / Legal Guardian Name-Need Court Papers / See Note or Letter)

W-H-Work Permit Application 4/29/10