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Veridian Credit Union Supplier Registration

Company Information

Company Name: Required.
Contact Name: Required.
Title: Required.
 
Phone Number: Required.Invalid format.
Fax Number: Required.Invalid format.
Federal Tax ID Number: Required.
 
Address: Required.
Address:
City: Required.
State: Required.Invalid format.
Zip: Required.Invalid format.
 
Email: Required.Invalid format.
Website URL:
 

Supplier Business Classification Information

Minority - A business that is at least 51% owned, managed and controlled by individual(s) identified as "minority." In the case of a publicly owned business, at least 51% of the stock must be owned and managed by minority(s). (SBA certification is not required)
If yes, indicate group:
African/Black American Asian American Bosnian Hispanic American Native American (American Indian, Aleut, Eskimo) Other

Woman - A business that is at least 51% owned, managed and controlled by individual(s) identified as "women." In the case of a publicly owned business, at least 51% of the stock must be owned and managed by women.

Small Business - A small business is a business that is classified as "small" under the guidelines set forth by the Small Business Administration. Business size is dependent on the NAICS code, the number of employees, and the annual sales of a given company. Please refer to www.sba.gov/size for more details.

Other minority-owned business - A business that is at least 51% owned, managed and controlled by minority(s) who are not identified above.

Are you certified?  Required. Please choose one.

Note: for each certification type checked, an expiration date is required.
Certification Type Expiration Date
Small Business Administration Invalid format.
NMSDC Affiliated Council Invalid format.
Women's Business Enterprise Nat'l Council Invalid format.
Other  
Business Type:
(Check all that apply)
Contractor
Distributor
Manufacturer
Retail Dealer
Service Provider
Value Added Retailer
Wholesaler
Other (please describe below)
  
Identify the goods and/or services you provide:
Advertising
Apparel
Attorneys
Batteries
Catering
Cleaning & Janitorial Service
Collection Service
Computers
Connectors
Construction
Electronics: Distribution
Employment Services
Fiber Splice Products
Power Supplies
Print
Promotion Products, Service
Salvage, Scrap Service
Remote Control
Studio Equipment
Telemarketing
Test Equip, Tools
Traps & Filters
Vehicle Service
Vehicle Fleet Mgmt/Auto Dealer
Courier Service
Electrical Services
Furniture Dealer
Landscaping Service
Office Supplies & Products
Safety
Security
Accounting & Billing Service
Coffee & Vending Service
Plumbing Heat & A.C.
Electrical Supply
Environmental Services
Florist
Glass
Locksmith
Pest Control
Real Estate Related
Shredding Services
Signage
Travel
Information Technology
Training/Employee Development
Consulting
Storage & Warehousing
Other (please describe below)