Document Number: ERD-12192
Description: This form is used by Employment Agents to register with the Division.
Division: Equal Rights
Comments: This form should not be used by Licensed Employment Agents.
Content Contact: Equal Rights Information
This version is an electronic Microsoft Word template that can be filled out
on your computer (if you have Microsoft Word). If you do not have
Microsoft Word, you should use the ERD-12192
version that is not fill enabled and should be printed and completed by hand.
MS Word Document Attachment: ERD-12192-E
This version is not fill enabled. It can be printed and completed by hand.
If you have Microsoft Word and want a form field fill-enabled form that can be
filled out on your computer you may use the ERD-12192-E
PDF Document Attachment: ERD-12192
***Should you require the necessary software to view the above attachment, please go to the DWD Viewers Download Page. Links to each specific vendor's site have been provided for you. Thank you.