Supplier Diversity Application
Company
First Name
Last Name
Email (we will keep your email completely private)
Address
City
State
Zip
Phone
Please give us the following information so that we may respond to your request quickly.
Diversity Status:
8(A) Designation
Disadvantaged Business Enterprise
Minority Business Enterprise
Small Disadvantaged Veteran
Woman Business Enterprise
Labor Surplus
Small Business
Woman owned Business
Disabled Veterans Business Enterprise
HUB Zone Certified
Service Disabled Veteran
Veteran Owned Business
Disabled Owned Business
Historically Black Colleges
Minority Owned Business
Vietnam Veteran
Products /Services that you would like
Safety-Kleen to purchase as part of
the Supplier Diversity Program: