Supplier Application

This Supplier Application is required for all suppliers wishing to conduct business with Grand Rapids Community College.

Company Information
ID Type
Organization Type
Mailing Address
Billing Address
Billing Address
Primary Contact
Secondary Contact
Secondary Contact
Supplier Questions
Do you accept Procurement Cards?
Do you accept electronic payments?"
Certifications
MDOT Certifications
MMBDC Certifications
City of Grand Rapids Micro-Local Business Enterprise
Women's Business Enterprise National Council (WBENC) Certifications
Other

Please list any other certifications

For Reporting Purposes
Ownership Percentage

Please list percentages. Enter 0% if not applicable.

%
%
%
Ethnicity
Are you a small business?
Are you located within the GRCC District?

Please check the appropriate NAICS commodity code.

NAICS Code
Category
Signature

Signature of person authorized to sign this application.

Signature