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Vendor Registration Form


We advocate the development and growth of minority and women owned vendors and suppliers. We seek opportunities to work with qualified vendors. If you are a vendor interested in working with us, please complete this form to add your information to our contact list.

Vendor Name *
Sales Contact Name *
Address Line 1 *
Address Line 2
City *
State/Province *
Zip/Postal Code *
Country *
Email *
Phone (XXX-XXX-XXXX) *
Ownership Structure
Year Established
Publicly Traded?
DUNS Number
Category - Primary *
Category - Secondary *
SIC/NACIS Code

  Are You Certified/Classified?
Disadvantaged Business Enterprise (DBE)
Hubzone Business
Minority Owned (MBE)
Women Owned (WBE)
Non-Profit Entity
Service Disabled Business (DVET)
Small Business Administration
8(A) Program (SBA)
Small Business Enterprise (SBE)
Small Disadvantaged Business Enterprise (SDB)
Veteran-Owned Business (VET)
Additional Comments: (1,500 character limit)



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