INSTRUCTIONS FOR A300 COMBINED CERTIFICATION FORM
1. Employment Information (section B) – After you have completed your personal information (section A), bring your
certification form to the employer. The employer completes the Employment Information and signs and dates the Promise of
Employment. If any of the employment details have been pre-filled and are incorrect, the employer must cross out the
incorrect information and enter, initial and date the corrections.
2. Physician’s Certification (section C) – The school district is responsible for performing the physical examination at no cost to
you or your parents. A school physical (including a sports physical) performed during freshman year is good for all four years
of high school (unless the school district policy specifies more frequent physicals).
If your parent/guardian prefers that you be examined by a doctor other than the one employed by the school district, you may
do so at your parent/guardian’s expense. A minor is not required to obtain a physical if the parent/guardian objects (in writing)
based on their religious beliefs and practices.
3. Proof of Age (section D) – If the school does not have a copy on file, you may be asked to provide a birth certificate, passport,
baptismal certificate or other identification documentation to the School Issuing Officer.
4. Parent/Guardian Authorization (section A) – Your parent/guardian must indicate his/her authorization of your employment as
specified in the Employment Information by signing and dating the Parent/Guardian authorization.
5. School Record/Issuing Officer Certification (sections E & F) - Present the completed certification form to your school district.
A designated school official will review the form and issue the working papers only after being satisfied that the working
conditions and hours will not interfere with your education. The official may refuse to issue working papers if such refusal
would be in your best interest.*
* See above Executive Order 13 (Murphy) (2020) for temporary instructions.
Hours of Work – 14 & 15 Year Olds
• no more than 3 hours a day on a school day
• no more than 18 hours a week during a school week
• may not work before 7:00 am or after 7:00 pm during the school year
• summer vacation: may work up to 8 hours a day, 40 hours a week, and may work up to 9:00 pm with written parental
permission (which must be on file with the employer)
Pursuant to Executive Order 135 (Murphy) (2020), for the duration of the Public Health Emergency declared in Executive
Order No. 103 (2020), the provisions of N.J.S.A. 34:2-21.8 and N.J.S.A. 34:2-21.10, requiring the personal appearance of the
minor, and, under certain circumstances, the minor’s parent or guardian, before school district issuing officers in order to apply
for or sign employment certificates may be satisfied through the use of audio-visual technology. Each public-school district
shall develop and implement procedures to satisfy the statutory requirements without requiring in-person contact between the
school district issuing official and the minor, under the following conditions: a. During the application process, the child and
the school district licensing officer may transmit a single copy of all required documentation by way of electronic transmission,
fax, or any other means of transfer of documents developed by the school district that avoids in-person contact, is secure, and
maintains the confidentiality of the documents; b. The video conference shall be live and must allow for interaction between
the child and the school district issuing officer, and when applicable, the parent or guardian. During the video conference, the
child shall verify his or her identity, authenticate the documents submitted, and sign the application, in a way that is visible and
audible to the school district issuing officer; and c. Following the video conference, the child shall transmit the signed
certificate, by electronic or other means as determined by the school district, to the issuing officer, who shall make the
requisite copies and distribute the original and copies as required by N.J.S.A. 34:2-21.7