Supplier Information

Location

Please fill out and submit this form if your company is interested in pursuing supplier opportunities with Temple University.

Return to the Supplier Diversity page for more information.

Company Name *

Street Address *

City *

State *

Zip *

Contact Name *

Email Address *

Phone Number

Fax Number

Dun & Bradstreet Number

Federal ID Number

Company Website

Gross Annual Sales (Based upon the last tax year) *

Number of Employees *

Legal Entity Type (Check all that apply) *

Sole Proprietorship

Partnership

Corporation

Nonprofit

Vendor Type (Check all that apply)

Construction

Goods

Services

Campus locations you wish to serve (Check all that apply)

Center City

Main

Health Sciences Center

Briefly describe your primary business product(s) or service(s) *

Agency Registration and/or Certification (Check all that apply) *

The Enterprise Center Minority, Women, and/or Disabled Business Enterprise Certification (M/W/DSBE)

Pennsylvania Unified Certification Program

U.S. DOT Office of Small and Disadvantaged Business Utilization

New Jersey Department of the Treasury Minority and/or Women Business Enterprise Certification

National Minority Diversity Council (NMSDC)

Eastern Minority Supplier Development Council (EMSDC)

SEPTA Disadvantaged Business Enterprise (DBE)

Women's Business Enterprise National Council WBE Certification (WBENC)

National Gay and Lesbian Chamber of Commerce (NGLCC)

Green Purchasing

Temple University is committed to the use and purchase of environmentally and socially responsible materials and products. Briefly describe how your product or service reduces the negative impact on human health and the environment.

Signature (Print Name) *

I acknowledge the information provided is accurate, may be used by the university for informational purposes, and does not guarantee any work or business. The undersigned acknowledges that the information contained herein is true and accurate.

Title

Please add your job title or company position.

Date *

Month

Day

Year

Certification File *

Choose your file and then hit upload.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt rtf pdf doc docx.

Capability File *

Choose your file and then hit upload.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt rtf pdf doc docx.

Leave this field blank

Institutional Diversity, Equity, Advocacy and Leadership

Location