Intent to Employ & Parental Approval

Medical Statement

Principal's Statement

Child Labor Laws

Hazardous Occupations

IL Department of Labor Work Permit Form

*Please note, if using Google Chrome, right-click on the link above, and select "Save link as". Download the form to your computer and open in Adobe.

1. Parents and employer read the excerpts from the Illinois Child Labor Laws

2. During the summer and for home schooled students, call to set up an appointment for a work permit - 217-893-3219. During the school year individual school districts will issue work permits.

3. Please provide all the required documentation as noted below.

4. Parent and minor must be present at the work permit appointment.

Staff will review documents with the parent/guardian and minor.

1. INTENT TO EMPLOY AND PARENTAL APPROVAL
   Use the form to the left- Intent to Employ & Parental Approval. The prospective employer completes section 1. The parent or guardian completes section 2.

2. PROOF OF AGE (ORIGINAL)
   An original birth certificate is preferred. If the original birth certificate is not available, we will accept one of the following: Baptismal certificate, passport, insurance policy or notice of birth registration.

3. ORIGINAL SOCIAL SECURITY CARD

4. VALID PHOTO IDENTIFICATION OF PARENT/GUARDIAN

5. MEDICAL STATEMENT (NOTE FROM PHYSICIAN)
   A signed physician’s statement on the physician’s or health institution’s letterhead, or the Medical Statement Form found to the left, indicating the child is physically fit to be employed.

6. PRINCIPAL’S STATEMENT (WAIVED DURING SUMMER MONTHS)
   The principal completes the Principal Statement, found to the left, verifying the student is active and in good standing academically.

7. PROOF OF COOGAN ACCOUNT (Blocked Trust Account)
   Applies to minors applying for a performing, acting, or modeling work permit.
   Examples of financial institutions to offer these accounts:
   Actors Federal Credit Union
   Wells Fargo
   Bank of America​​​