Republic of the Philippines

DEPARTMENT OF LABOR AND EMPLOYMENT

Regional Office No. __________
Provincial/Field Office ________

WORKING CHILD PERMIT Passport

APPLICATION FORM Size
Photo
PERSONAL DATA OF THE CHILD 3.5 cm. x 4.5 cm.
Name of Child: _________________________________________________________________________________________
(Last Name) (First Name) (Middle Name)

Home Address: _________________________________________________________ Contact Details: _________________

Date of Birth: ___________________________ Place of Birth: ______________________________________ Age: _____
Sex:  Male  Female Education:  Grade level (specify if applicable) __________________________
NAME OF PARENTS/GUARDIAN
Father: _______________________________________________________________ Occupation: _____________________________________________________
Mother: _______________________________________________________________ Occupation: _____________________________________________________
Guardian: _____________________________________________________________ Occupation: _____________________________________________________

A. FOR PUBLIC ENTERTAINMENT OR INFORMATION

Terms and Conditions

Title of Project/Activity: _____________________________________________________________________________ Talent Fee _______________________
Description of role of the child: ______________________________________________________________________________________________________

Date/s Location (Specify details) Call Time No. of Hours of Work

Note: Please use extra sheet if necessary

The following are provided to the child:
 comfortable workplace and adequate quarters  all the necessary assistance to ensure adequate and immediate medical
 break or rest periods in comfortable day beds or couches and dental attendance and treatment to an injured or sick child in case
 clean and separate dressing rooms and toilet facilities for boys and girls of emergency
 adequate meals and snacks and sanitary eating facility  others, please specify _______________________________________
Data on Employer
 Producer  Advertiser  Ad Agency  Talent Caster  Talent Agent  Talent Manager  Others, specify ___________
Name of Establishment/Company: _______________________________________________________________ Tel. No.: ______________________________
Address: ____________________________________________________________ Fax: ___________________ E-mail: _______________________________
Business Permit No./Mayor’s Permit No.: _______________________________________ Date Issued: _______________________ Valid Until: ____________

B. FOR FAMILY UNDERTAKING

The child works under the sole responsibility of  parent  guardian  family member other than parent, specify _______________________
Nature of business/undertaking: _________________________________________ Location: ____________________________________________________
Specify the child’s activity or work: _____________________________________________________________________________________________________

I hereby certify that the information contained herein are true and correct to the best of my knowledge.

_________________________________________ ________________________________________ _________________________________________

Printed Name and Signature of Employer Printed Name and Signature of Authorized Printed Name and Signature of
Network Representative, if for Television Parent/Guardian
_________________________________________
Designation

ACTION OF DOLE REGIONAL/PROVINCIAL/FIELD OFFICE

DOCUMENTS SUBMITTED

FIRST APPLICATION SUCCEEDING APPLICATIONS

 Notarized and duly accomplished WCP Application Form  Notarized and duly accomplished WCP Application Form
 Proof of schooling (any of the following)  Previously issued WCP Card
 Certificate of Enrollment  Proof of schooling (any of the following)
 Current School ID  Certificate of Enrollment
 Certified True Copy of Current Report Card  Current School ID
 If the child is not enrolled, Notarized Affidavit that the child shall be enrolled in  Certified True Copy of Current Report Card
the next school year (if applicable)  Medical Certificate issued by a licensed physician, showing the physician’s full
 Authenticated copy of the child’s Birth Certificate or Certificate of Late name, signature and license number (valid within 1 month from date of
Registration of Birth issued by the Philippine Statistics Authority or issuance)
city/municipal registrar  Two (2) passport size photographs of the child
 Medical Certificate issued by a licensed physician showing the physician’s full  Any valid government issued ID of parent/guardian
name, signature and license number (valid within 1 month from date of  Trust Fund Certificate issued by a bank under the child’s name (if applicable)
issuance)  When the employer is the parent, guardian, or a family member other than the
 Two (2) passport size photographs of the child parent of the child
 Any valid government issued ID of parent/guardian  For legal guardian – Authenticated proof of legal guardianship
 When the employer is the parent, guardian, or a family member other than the  For family member – Proof of relationship to the child
parent of the child  When the employer is in public entertainment or information
 For legal guardian – Authenticated proof of legal guardianship  Certified true copy of the employer’s business permit or Mayor’s
 For family member – Proof of relationship to the child Permit
 When the employer is in public entertainment or information  Notarized Employment Contract between the employer and the
 Certified true copy of the employer’s business permit or Mayor’s child’s parents or guardian
Permit  Application fee (P100.00)
 Notarized Employment Contract between the employer and the
child’s parents or guardian
 Application fee (P100.00)

Date Received:__________________