Supplier Diversity Program

* Required fields

*Vendor Category:

Newly approved vendor

Prospective vendor

Existing vendor

*Company Name:

*Contact Person & Title

*Phone

*Email

*Website

Year Established

*Product & Service —Please indicate below the product or service your company provides (please be brief, but specific.)

What is your business geographic coverage area?
National Local Both

*Are you a Minority-Owned Business? A business is minority-owned if it is at least 51% owned, operated and controlled by one or more minority group member(s).
Yes No

*If yes, please indicate ethnic origin:
African American/Black
Latinx/Hispanic American
Native American
Asian/Indian American
Native Hawaiian/Pacific Islander
Other

*Are you a Women-Owned Business? A business is women-owned if it is at least 51% owned, operated and controlled by one or more women.
Yes No

*Are you a Lesbian, Gay, Bisexual, and/or Transgender-Owned Business (LGBTQ)? A business is LGBTQ+-owned if it is at least 51% owned, operated and controlled by a LGBTQ person or persons.
Yes No

*Are you a Veteran-Owned Business? A business is veteran-owned if it is at least 51% owned, operated and controlled by one or more veterans.
Yes No

*Are you a Disability-owned Business Enterprise (DOBE)? A business is a disability-owned enterprise if it is at least 51% owned, operated and controlled by one or more persons with a disability.
Yes No

*Are you a Small Business Enterprise (SBE)?
Yes No

*Are you a Small Disadvantaged Business (SDB)?
Yes No

Certifications
Cadwalader does not require your business to be certified as a minority-owned, women-owned, LGBTQ-owned and/or veteran-owned business to be included in our database. However, if it is, please let us know by checking the box(es) below.

*MINORITY-OWNED BUSINESS CERTIFICATION—Is your business presently certified as a minority-owned or women-owned business with the National Minority Business Council (NMBC), the Small Business Administration, or an affiliated Council of the National Minority Supplier Development Council (NMSCD), or any other government agency? (If you identify as a SDB or SBE you must submit your certification)

Yes No

*LESBIAN, GAY, BISEXUAL, and/or TRANSGENDER BUSINESS CERTIFICATION—Is your business presently certified as a LGBTQ+-owned business with the National Gay and Lesbian Chamber of Commerce (NGLCC), or any other government agency?

Yes No

Trade References (optional):

Name

Address

Phone

Name

Address

Phone

Name

Address

Phone

I certify the information contained in this form is correct:

*Name

*Company

*Title

*Date

*Signature

The parties agree that to the extent they sign electronically, their electronic signature is the legally binding equivalent to their handwritten signature.

Address

*Fed. ID#

Phone

Fax

Please be advised that submission of this form is for statistical purposes only. It is not a guarantee of business and does not ensure “approved” vendor status. You will be contacted at Cadwalader’s discretion. Submissions providing products/services not currently sought will be maintained for future consideration. Please note that we are not seeking information on individual persons, only companies.

Supplier Diversity Program - Registration Form