New Supplier Diversity Profile

Contact Information Legal Name of Company:
Address:
Address:
City:
State/Province:
Contact:
Contact Title:
E-mail Address:
Telephone Number:
Fax Number:
Website Address:

Business Ownership Classification

Please indicate your company is at least 51% owned and operated by one or more of the following groups:

African American
Asian-Indian American
Hispanic American
Asian/Pacific Islander
Non-Minority Woman
Native American
Other

Please indicate

Is your company certified by a government agency, National Minority Development Council, Women's Business Enterprise National Council as a Minority, Women-owned or business enterprise? (If so, enter all applicable agency names, certificate numbers and expiration dates.)

Enter Certificate Number and Expiration:

Business Information

Legal Structure:
Federal Tax ID #:
Year Established:

Please contact Patricia Glass (650) 964-4617 x 102 for more information regarding the Sharper Technology Supplier Diversity Program.

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New Supplier Diversity Profile

New Supplier Diversity Profile

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