Apply For Membership

Thank you for deciding to become a corporate member
of MMSDC. We are happy to have you!

For Corporations Only

Please note that this application is for majority-owned corporations or government agencies only to complete. If you are a minority-owned business, you need to become a certified MBE in order to join our constituency.

Corporate membership application (1P)

Company Information
Company name*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Main office phone*
Main fax number*
Website*
Description of primary business*
Is your company in the Non-Profit, Education, or Government sectors?*
- Yes
- No
Please select the industry group that best describes your business*
- Commercial Products/Services
- Construction
- Consumer Products
- Financial & Insurance Services
- Healthcare
- Information Technology
- Manufacturing
- Professional
- Transportation
Number of Employees in U.S.
Major Customers
Please list the names of 3 companies that your business works with.
Company 1*
Company 2*
Company 3*
Referral, industry and previous policy information
Did a member of MMSDC refer you to join?*
- Yes
- No
Who referred you to join MMSDC (name, company)?*
Do you currently have a supplier diversity program/policy in place that identifies and measures dollars contracted with MMSDC certified minority business enterprises (MBEs)?*
- Yes
- No
Upload your supplier diversity policy*
Accepted file types: pdf, jpg, tif, png, Max. file size: 256 MB.
Your CEO Information
CEO name*
First Last
CEO phone*
Extension
CEO email address*
Your Primary Contact Information
Name*
First Last
Job title*
Phone*
Phone extension
Fax*
Email address*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Secondary Contact Information
Name*
First Last
Job title*
Phone*
Phone extension
Fax*
Email address*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Payment & Checkout
Payment Type*
- Credit Card
- Invoice
Corporate Membership Annual Fee - Level 1*
Price:
Corporate Membership Annual Fee - Level 1 (Non-Profit, Gov't Education)*
Price:
Corporate Membership Annual Fee - Level 2*
Price:
Corporate Membership Annual Fee - Level 3*
Price:
Corporate Membership Annual Fee - Level 4*
Price:
Total amount due
$0.00
Credit card information*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Credit Card Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Where would you like us to email a receipt of the above submitted data and billing summary?*

Apply For Membership

For Corporations Only

Corporate membership application (1P)

Company Information

Major Customers

Referral, industry and previous policy information

Your CEO Information

Your Primary Contact Information

Secondary Contact Information

Payment & Checkout