Form B "Hire Access Request Form" - Louisiana

What Is Form B?

This is a legal form that was released by the Louisiana Workforce Commission - a government authority operating within Louisiana. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on April 1, 2021;
  • The latest edition provided by the Louisiana Workforce Commission;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form B by clicking the link below or browse more documents and templates provided by the Louisiana Workforce Commission.

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APPENDIX 1: ELIGIBLE TRAINING PROVIDER FORMS
rd
1001 North 23
Street
225-342-7692
(O)
John Bel Edwards, Governor
225-342-7690
Post Office Box 94094
(F)
Ava Dejoie, Secretary
Baton Rouge, LA 70804-9094
www.laworks.net
Office of Workforce Development
HiRE Access Request Form
Please complete this form and upload into the Documents Section of the Provider Profile
Section 1: Provider Information
1. Name of Institution:
2. Institutional Code:
Section 2: HiRE Access
Access Type
Name of Contact:
Title:
Phone #
Email:
HiRE User Name:
HiRE Security Question and Answer:
I. The ‘Training Provider User’ shall not perform any illegal, fraudulent or dishonest action
II. The ‘Training Provider User’ shall be responsible and accountable for all computer transactions logged against his/her password.
III. The ‘Training Provider User’ shall be the sole user of the User ID mentioned above throughout their duration of their employment with
Training Provider Institution
IV. Any additions or amendments to this agreement may be implemented and become effective by a showing that the ‘Training Provider
User’ was given notice of the addition or amendment and without need for republishing and signing a new agreement.
I understand that this agreement (or a signed revision thereof.) will remain binding throughout my entire user access of the Training
Provider Profile. I agree to abide by this policy and understand that non-compliance with any part of the policy may constitute grounds
for disciplinary action which may include, but is not limited to, the following:
1.
A letter of warning
2.
Removal of User Access
3.
Removal of Program(s) ETPL Eligibility
4.
Inactivation of Provider Profile and
User ID
FAILURE TO SIGN THIS AGREEMENT WILL RESULT IN DENIAL OF PROVIDER PROFILE ACCESSS TO USER ID.
I do hereby certify that I have read, understand, and have been given a copy of HiRE Information Access Agreement
X
Signature
Date
Send questions to CRS@lwc.la.gov
Form B: HiRE Access Request Form
Page 1 of 1
04/21
APPENDIX 1: ELIGIBLE TRAINING PROVIDER FORMS
rd
1001 North 23
Street
225-342-7692
(O)
John Bel Edwards, Governor
225-342-7690
Post Office Box 94094
(F)
Ava Dejoie, Secretary
Baton Rouge, LA 70804-9094
www.laworks.net
Office of Workforce Development
HiRE Access Request Form
Please complete this form and upload into the Documents Section of the Provider Profile
Section 1: Provider Information
1. Name of Institution:
2. Institutional Code:
Section 2: HiRE Access
Access Type
Name of Contact:
Title:
Phone #
Email:
HiRE User Name:
HiRE Security Question and Answer:
I. The ‘Training Provider User’ shall not perform any illegal, fraudulent or dishonest action
II. The ‘Training Provider User’ shall be responsible and accountable for all computer transactions logged against his/her password.
III. The ‘Training Provider User’ shall be the sole user of the User ID mentioned above throughout their duration of their employment with
Training Provider Institution
IV. Any additions or amendments to this agreement may be implemented and become effective by a showing that the ‘Training Provider
User’ was given notice of the addition or amendment and without need for republishing and signing a new agreement.
I understand that this agreement (or a signed revision thereof.) will remain binding throughout my entire user access of the Training
Provider Profile. I agree to abide by this policy and understand that non-compliance with any part of the policy may constitute grounds
for disciplinary action which may include, but is not limited to, the following:
1.
A letter of warning
2.
Removal of User Access
3.
Removal of Program(s) ETPL Eligibility
4.
Inactivation of Provider Profile and
User ID
FAILURE TO SIGN THIS AGREEMENT WILL RESULT IN DENIAL OF PROVIDER PROFILE ACCESSS TO USER ID.
I do hereby certify that I have read, understand, and have been given a copy of HiRE Information Access Agreement
X
Signature
Date
Send questions to CRS@lwc.la.gov
Form B: HiRE Access Request Form
Page 1 of 1
04/21