Membership Application

Contact Name *

First

Last

Company Name *

Company Address *

Company Phone *

Company Fax *

Company Email *

Company Website *

Type of Entity *

Business Start Date *

MMGSA Membership Information *

Member Requirements

The organization is certified as a minority-owned business. The organization has been in business for 3 year & for-profit. The organization is good standing with the Secretary of State.

MMGSA Membership Information *

Associate Member Requirements

The organization is good standing with the Secretary of State. The organization supports diverse supplier base and workforce.

Number of Employees & Fee *

Last Year Sales *

MBE Ownership *

Where do you provide goods and services? *

How did you hear about MMGSA? *

MMGSA Referring Member or Firm

Certifications *

If you selected "other" for certifications, please list:

Are you interested in joint ventures opportunities? *

What are your goods and/or services? *

What is your industry? *

Please add your NAICS Codes *

Acceptance of Application *

Provide 3 business references (Name, Organization, Email, & Phone Number)

Acceptance of Application - Signature (Full Name) & Date *

If this application is accepted by the board of directors, the member of MMGSA agrees to abide by the bylaws of the organization.

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