Isle of Wight Council

WM8 Application/ Certificate For Child Employment

The Byelaws of the Isle of Wight Council 1998, The Children and Young Persons Act 1933 ? 1963, The Education Act 1996 and The European Community Council Directive 94/33/EC, "Protection of Young People at Work" Note: Any employer and any other person contravening the laws and bylaws covering child employment is liable, on summary conviction, to a fine not exceeding �1000.

	Application (to be completed by employer/child)
	Childs Details

*	Date of commencement of employment
*	School attending

*	Childs forename
	Childs Middle name/Initials
*	Childs surname
	Date of birth

*	Building/house name/number
*	Street address
*	Town name
	County
*	Postcode
	Telephone number (include area code)
	Email address

Employers Details

*	Employers forename
	Employers middle name/Initials
*	Employers surname

*	Employers building/house name/number
*	Street address
*	Town name
	County
*	Postcode
	Telephone number (include area code)
	Email address
	Fax
	Contact person
	Place of employment (Telephone number if different)
	Nature of work (please specify main duties)

Days/times of employment

	Weekday	Start Time	Finish Time
	Monday
	Tuesday
	Wednesday
	Thursday
	Friday
	Saturday
	Sunday

Total hours of employment

	On school days
	School holidays

	Saturdays
	Sundays

Declaration

Declaration by the employer: I/we certify that the particulars given above are correct and that I have checked on the maximum of hours to be worked according to the bylaws of the Isle of Wight Council. I/we believe my employees aged 13 and 14 do "light work" only. I/we have completed a risk assessment

*	Employer Signature	Signed............................................................... Name................................................................ Date..................................................................
*	Child Signature	Signed............................................................... Name................................................................ Date..................................................................
*	Parent Signature	Signed............................................................... Name................................................................ Date..................................................................

Please return the completed form within 7 days of commencement of employment together with a copy of your completed risk assessment to:  Business Support Team Schools & Learning Division (Chief Executive's Department) County Hall Newport Isle of Wight PO30 1UD

Approval/ Certificate: (to be completed by the Local Authority)

	I can/cannot give approval of the employment based on the information given above. (If not approved please state reasons)

Expiry Date (12 months after issue date)

Signed

Signed............................................................... Name................................................................ Date..................................................................

This certificate should be retained by the child's employer and should be shown, on request, to an Education Welfare Officer, a police officer, a factory inspector, a safety inspector or any duly appointed officer of the council. This certificate is not transferable. It is the employer's responsibility to notify the LA of any significant changes to the child's employment.

For LA use only: ID number:

Copies to be sent to: LA: employer: child: EWO: Environmental Health

	Data Protection Act 1998
	This application may be monitored by the Isle of Wight Council for regulatory, quality control or crime detection purposes. Information from this application will be processed in accordance with the Data Protection Act 1998 for the purpose of processing your particular enquiry/request. The Isle of Wight Council ("the Council") is the data controller. By completing this form you consent to the Council contacting you by email or nominated contact method in relation to your enquiry/request. The information contained in this application may, in exceptional circumstances, be subject to disclosure to third parties under either the Data Protection Act 1998 or the Freedom of Information Act 2000 to the extent the law allows and in accordance with the Isle of Wight Council's Access to Information Policy . Disclosure will only be made where in all the circumstances it would be fair to do so and in the public interest. Please note that the Council may process your information in the absence of consent for the purpose of crime prevention or detection so far as is in accordance with the law. Sometimes we may use your information to keep you informed about services, goods or relevant issues that we believe may be of interest to you. If you wish to receive this information for these purposes please tick this box To improve the quality of other services that we provide to you the Council wishes to hold your non-sensitive personal information on a secure central database. This will enable all Council services to use this information when they are providing a service to/for you. If you wish your non-sensitive personal information to be held by the Council please tick this box

Date printed: 07/03/2013