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Apply/Register as a Supplier

Diverse Business Resources

Lysander Supply Solutions

Apply/Register to Become a Supplier*


Date: *
Name of Company: *
Address: *
Address 2:
City: *
State: *
Zip: *
Phone: *
Fax: *
E-mail:
Web site:
Contact Name: *
Contact Title: *
Name of President/CEO: *
Number of Offices: *
How long has your company been in business? *
Is your company considered a diverse business? *
Yes No
What type of business is your company? *
MBE certified - minority owned
WBE certified - women owned
Service-disadvantaged, veteran-owned small business
SB - small business
SDB certified - small disadvantaged
VET certified - veteran owned
HZSB certified - HUBZone small business
Other
If other, please explain:
Certificate number: *
DUNS number: *
What products/services does your company offer? *
If other, please explain:
* Application/registration does not guarantee a partnership with Applied Industrial Technologies. Applicants will be evaluated individually, and an Applied® representative will contact you if there is an opportunity to establish a supplier or teaming arrangement.



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