Be Aveda Institutes

Company Information

* Firm Name

Name as listed on W-9.

* Address

* City

* State

* ZIP Code

County

Country

* Telephone

Fax

* Company Email

The email address must be that of the authorized company. Personal email or physical addresses of sales representatives are not acceptable.

Tax Information

Federal Taxpayer Identification Number

As shown on W-9 form.

Social Security Number

If appropriate.

Address for Payment

City

State

ZIP Code

Country

Authorized Personnel

Authorized Company Officer & Title

Authorized Sales Representative

Minority / Disadvantaged Business Information

A minority business is defined as a business that is both owned and controlled by minorities and/or women. Minorities and/or women must own at least 51% of the business and control its management and daily operations. Minorities include Black, Women, American Indians, Alaskan Natives, Asian American, Hispanics and members of other groups determined to be economically or socially disadvantaged by the Small Business Administration under Section A of the Small Business Act as amended (15 USC 637 a). HUB Zone business as determined by the Small Business Administration is a small business located within a HUB Zone.

Business Information

* Organization of Business

Registered Vendor on eSchoolMall?

Yes No

Employment Information

Are you currently an employee or retiree of the Memphis City Schools or Shelby County Schools District?

Yes No

Have you ever been an employee of the Memphis City Schools or Shelby County Schools District?

Yes No

Last Date of Employment

NIGP / Commodity Codes

Please add NIGP Codes that best describe your product or service.

Comm Code 1

Comm Code 2

Comm Code 3

Comm Code 4

Comm Code 5

Comm Code 6

Attachments

Please attach your completed W-9 form. International vendors need to attach their completed W-8BEN form. If you do not already have a completed W-9 or W-8BEN form, please download it from www.irs.gov and complete the form before adding it as an attachment.

* W-9 / W-8BEN Attachment

Accepted file types: PDF, DOC, DOCX. Maximum file size: 10 MB.

VENDOR REGISTRATION