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Vendor Registration
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Company Name:
Address:
City, State Zip:
Phone: ext.
Contact:
Contact Title:
Contact Email:
Company Website:
Product Categories:
(Check all that apply.)
Art
Athletic
Audio/Video
Cafeteria/Kitchen
CEX Facility/Equipment
Furniture
Health/Wellness
Janitorial
Office
Paper
Promotional Items
Technology
Description of the products and/or services:
Does your company offer any special pricing for education or public agencies?
Does your company offer purchasing through an online store?
Is your company part of an existing purchasing agreement? (Check all that apply.)
AEPA
E & I
GSA
KCDA
NASPO Value Point
National IPA
NJPA
Other
State of Oregon
TCPN
US Communities
Please provide a copy of your W9 form. (PDF Only)
Is there any other information you would like to provide about your company?
How did you hear about us?
Other:
Thank you for your interest in our business!
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