Supplier Diversity Vendor Application

	The Bureau Of National Affairs, Inc Supplier Diversity Vendor Application

Company Name:
Contact Name:
Phone:
Email:
Address:
City:
State:
Zip Code:

Business Type (check all that apply): College/University Corporation	Individual/Sole Proprietor Joint Venture	Other Partnership

Business Ownership (check all that apply): African American Asian Indian American	Asian Pacific American Hispanic American	Native American

Business Classification (check all that apply): Disabled Veteran Historically Black College/University HubZone	Minority Institution Physically Challenged Small Business	Small Disadvantaged Business Veteran Woman-Owned

Has your company

been certified by a third party organization?

Yes No

Annual Revenues:
Number Of Employees:
Principal Product Or Service:
Secondary Product Or Service:

In accordance with U.S. Government regulations, we are required to verify the business size and classification of our suppliers on a regular basis. BNA is committed to fostering the economic growth within the minority business community and encourages companies to obtain third party certification as a small, minority, disadvantaged or HUBZone business. To aid us in validating/maintaining current supplier data records, please complete all required fields.