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Primary Industry
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Accounting
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Printing / Bet Slips
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Vending Machine
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Contact Information
Name
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Job Title
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Email
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Phone
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Fax
Other Information
Owner Title
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Owner First Name
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Owner Last Name
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Is the owner a US Citizen?
Yes
No
Annual Revenue
Under $500,000
$500,000 - $1 Million
$1 Million - $2 Million
$2 Million - $5 Million
$5 Million - $10 Million
$10 Million - $12 Million
$12 Million - $15 Million
$15 Million - $20 Million
$20 Million+
Number of Full-Time Employees
Under 25
25 - 50
50 - 100
100 - 500
500+
Number of Part-Time Employees
Under 25
25 - 50
50 - 100
100 - 500
500+
Supplier Diversity Group Member
African American
Asian Indian
Asian/Pacific Islander
Disabled Business
Disabled Veteran Business
Hispanic
Native American
Veteran Owned
Woman Owned
Certification(s)
Veteran-Owned
DVBE
Sheltered Workshop
HUB Zone
Small Business Enterprise
Select all that apply.
Are you certified with NMSDC?
Yes
No
Are you certified with WBENC?
Yes
No
Are you a current SG vendor?
Yes
No
Are you able to hire sub-contractors if necessary?
Yes
No
Do you have a company brochure?
Yes
No
Do you have an organizational chart?
Yes
No
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