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Home > Inside Scientific Games > Supplier Diversity > Supplier Diversity Application

Supplier Diversity Application Form

(*) required fields
Business Information
*Business Name:
*Address:
*City:
*State:
*Zip:
*Website: http://
leave as 'N/A' if you don't have a website
*Industry:
Hold the 'ctrl' button down to select multiple options

Contact Information
*Name:
*Job Title:
*Email:
*Phone:
Fax:

Other Information
*Owner Title:
*Owner First Name:
*Owner Last Name:
Is the owner a US Citizen?:
Annual Revenue:
# of Full-Time Employees:
# of Part-Time Employees:
Supplier Diversity Group Member:


Certification(s):
State Certification If Other, please enter here

Select all that Apply:
 

Select either Yes or No:
Are you certified with NMSDC?
If so , which affiliate?
Are you certified with WBENC?
Are you a current SG vendor?
Are you able to hire sub-contractors if necessary?
Do you have a company brochure?
Do you have an organizational chart?

Business References:
   Name  Phone #
#1:
#2:
#3:

Company Capabilities:
Comments:
   




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