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Get OSB-8 Contractor Access Card Enrollment Form.docx - Doa Louisiana

Rollment Form OSB Badging Office s Telephone Number: (225) 219-4799 Fax the completed and signed forms to (225) 219-9309 Access Cardholder Information Contractor s First Name: Last Name: Date of Birth (mm/dd/yy): La. Driver License No.: Company s Name: Company s Address: Company s Phone Number: Supervisor s First Name: Last Name: Supervisor s Job Title: State Agency Information Agency: Department: Building Name: Telephone (work): Building Access Code(s) & Access Time(s) Buil.

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