Hub Vendor Registration
Company Name
First Name
Last Name
Owner
First Name
Last Name
Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Contact Name:
First Name
Last Name
Contact Phone:
Please enter a valid phone number.
Format: (000) 000-0000.
Contact E-mail:
example@example.com
Contact Name 2:
First Name
Last Name
Contact 2 Phone #
Please enter a valid phone number.
Format: (000) 000-0000.
Contact 2 E-mail:
example@example.com
Type of Ownership:
Please Select
Corporation
Franchise
Partnership
Sole Proprietor
Other
Business Size:
Please Select
Large
Small
Number of Employees:
How long in Business:
Please upload your Business License
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Please Upload Your Articles of Formation(documentation identifying each member's ownership, liability, and responsibilities in the company)
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NAICS Number:
Type of Business (NAICS Industry Type)
Description of Products or Services:
Minority Owned
Please Select
Yes
No
Minority Category
Please Select
Black
Native American
Hispanic American
Women Owned
Asian Pacific American
Disabled Veteran
Please Upload your Certification of Hub/Minority Status (if applicable)
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Please include the last three contracts or sales your company has completed including customer names and addresses, contact information, contract amount and completion.
Please upload your completed form W-9. (If you do not have one, please contact a Birmingham Business Resource Center Team Member).
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