Vendor Registration

* required information.

Business Name *

Address Line 1 *

Address Line 2

City *

State *

Zip Code * Not a number.

Type of Entity *

Business Headquarters / Primary Business Location

Contact Name *

Phone * Not a valid phone number.

Fax

Email Not a valid email address.

Is your company authorized to collect AL Sales Tax? *

Yes No

Permit Number

Years in Business

Small Business: Small Business Association Size Standard Tool Yes No

Minority, Women or Disadvantaged Owned Business Information.

Owned and Controlled (at least 51% owned by one or more socially or economically disadvantaged individuals or stock) Yes No

This business qualified by virtue of 51% or more ownership and active management by the following: *

American Indian or Alaskan native
Hispanic
Asian American
African American
Woman
Disadvantaged
Not Applicable

Sex: Male Female Other

Has your firm been certified as a Minority, Woman or Disadvantaged Enterprise? *

Yes No

Specify certifying agency:

Certification Type:

Date of certification:

Diversity Category

NAISC Code

Product or Service *

What to do while at the BJCC

Attending an event

Planning an event

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