Small and Undeserved Supplier Program Application

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Contact Person

Name

Phone

Email

General Company Information

Type of Business

Categorize the products or services offered by your company. Select all that apply.

Multi-select: Ctrl+Click or Cmd+Click

Please specify

Describe your company's product or service

List NAICS Product Code(s)

Are you a member of a Group Purchasing Organization?

NoYes

Enter the name of the Group Purchasing Organization

What percentage of your company sales is within education?

Small and underserved supplier information

A small business participating in the SBA 8(a) Business Development Program. The company must be at least 51% owned and controlled by socially and economically disadvantaged individuals who are U.S. citizens.

Is your company a small and underserved supplier?

NoYes

Check all that apply

Multi-select: Ctrl+Click or Cmd+Click

Notes

Upload certification of designation as elected small or disadvantaged business

To be recognized through the Small and underserved suppliers program, companies must be certified through an official certification agency. For details, please contact either of the following agencies directly:

SBE Certificate Number

NAICS Code

Contact Information

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