Profile Information
Thank you for taking the time to register your company profile. Once you have filled out the form below, click "save".

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Company Profile
 Company Name: 
 DBA: 
 Main Phone:   (XXX) XXX-XXXX
 Main Fax:   (XXX) XXX-XXXX
 Web Site: 
 Account Email: 
Address Information
 Street Address: 
 Address 2: 
 City: 
 State: 
 Zip: 
 County: 
 Country: 
 
    Mailing Address Same as Street Address
 
 Mailing Address: 
 Mailing Address 2: 
 Mailing City: 
 Mailing State: 
 Mailing Zip: 
 Mailing County: 
 Mailing Country: 
Contact Information
The following company representative has been designated and authorized to maintain company information on this website and understands that this information with the exception of procurement data is publicly accessible and may be shared with other related web sites.
First Name: 
Last Name: 
Title: 
 Contact Phone:   (XXX) XXX-XXXX
E-Mail: 
I am fully authorized to maintain company data: 
Additional Information
 Industry Classification: 
 Disadvantaged Business Enterprise: 
 Import and/or Export Experience:   Yes
 Primary Affiliation: 

Choose Affiliations: 
ETIC: 
AMIT: 
BIO-SA: 
Plastics: 
GAZEL: 
Nano: 
BusinessLINC: 
Existing Product/Service Offerings: 
(Maximum of 1500 characters - approx. 200 words)

Keywords: 

New Product/Commercialization Activities: 
(Maximum of 1500 characters - approx. 200 words)

Extended Capabilities: 


Confidential Profile Information to Enable Us to Serve You Better
For Internal Use Only By Database Admin.
Confidential Capabilities: 
Employee Range: 
Annual Sales Range: 

Will your company be experiencing business expansion and/or relocation in the next 12 months?:   Yes

 Are your purchasing decisions made locally?:   Yes

 What is your estimated annual procurement budget: 

 What % of this budget is spent in Southern Arizona?: 

 What % of this budget is spent outside the United States: 

 What % of this budget is allocated for disadvantaged businesses?: 
Email Updates
 Yes! I would like to receive Email Notifications about the following items: 
 Newsletter
 Opportunity Forums
 New Bids / Projects
 Advisory Roundtables
  Supplier Tradeshows
 Special Events
 Cluster Events
 Federal Grant Funds
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