1. Supplier of the Year Awards Program
MBE Nominee Profile Worksheet
(TO BE FILLED OUT BY NOMINEE WITH COUNCIL STAFF ASSISTANCE, BASED ON CORPORATE
RECOMMENDATION—WORKSHEET MUST BE TYPED—FOR ITEMS 3-6, PLEASE PROVIDE A
SEPARATE STATEMENT FOR EACH SECTION, NOT TO EXCEED 250-300 WORDS)
ITEM 1: CATEGORY/CLASS:
Please select the class for this nominee:
ANNUAL SALES LESS THAN $1 MILLION .......................................... CLASS 1
ANNUAL SALES BETWEEN $1 MILLION AND $10 MILLION .......... CLASS 2
ANNUAL SALES BETWEEN $10 MILLION AND $50 MILLION......... CLASS 3
ANNUAL SALES GREATER THAN $50 MILLION…………………… CLASS 4
ITEM 2: GENERAL NOMINEE INFORMATION:
Principal Officer/Owner:
Title
Company:
Business Address:
City/State/Zip:
Business Telephone: ( ) Fax: ( )
E-mail
Race/Ethnic Identification:
Afr