Houston – Updated Minor Certification Number Child’s Legal First Name: * Child’s Legal Last Name: * Child’s Certification Number from GA Dept. of Labor: * Please be sure to input the full number including the first letter of the Certification Number. Child’s Date of Birth: * Last Four Digits of Child’s Social Security Number: * (required by GA Dept. of Labor) Child’s Gender: * Male Female Non-Binary Transgender Intersex Other Parent/Guardian’s First and Last Name: * Parent/Guardian's First and Last Name: First First Last Last reCAPTCHA Submit