Corporate Membership Application Company Name* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Telephone*E-mail* Contact Person Name (Individual who will participate in monthly meetings and other events)Contact Person Title Contact Person TelephoneContact Person E-mail Gross Annual RevenueCheck on or more boxes relative to applicant's interest Establishing a minority purchasing program Consulting with the TSMSDC to upgrade existing minority purchasing program Designating a senior executive to serve on the Board of Directors Event Sponsorship Other OtherProducts or services you buyPlease describe nature of companyIs company a member of the National Supplier Development Council? Yes No Location of Corporate OfficeIs minority purchasing data reported to or by your Corporate Office? Yes No By signing this application, your company’s commitment will be to: Establish a minority purchasing program, if one does not exist. Report monthly, quarterly or annually the total dollars of purchases made from minority businesses in accordance with the Corporate Reporting form. Designate a company representative (Purchasing Agent) to attend Council meetings and other special events. Payment of Corporate Membership dues (annually). Name* Title* Signature*