Grant Thornton Supplier Diversity

Registration Form

Please provide information about your company and your diverse status. If you are not currently a vendor of Grant Thornton, we will keep your information on file and we will contact you if we are interested in your products or services. Submitting information on this form does not guarantee or imply any relationship between your company and Grant Thornton. Please direct any questions to SupplierDiversity@us.gt.com.

Are you currently a vendor of Grant Thornton? *This question is required.

Company Headquarters Information

Please enter the company headquarters information *This question is required.

Company Name

Street Address

Apt/Suite/Office

City

State

Zip

Country

Phone Number

URL

Tax ID (numbers only, no dashes)

Contact Information

Please provide your contact information.

First Name

Last Name

Title

Phone Number

Alternate Number

Email Address

Legal Acknowledgement
I certify I am authorized to provide this information to Grant Thornton. I understand Grant Thornton is not responsible for the information gathered herein, but that it will be kept confidential, except to the extent that it must be disclosed to regulatory authorities. *This question is required.

Company Profile Information

Ownership *This question is required.

Year business was established *This question is required.

Supplier Diversity
If your company is certified as a diverse supplier, please identify all of the certifying agency categories that apply: *This question is required.

Disabled Person-Owned Business
Historically Underutilized Business/HUB Zone
LGBTQ
Minority Business Enterprise
Service Disabled Veteran-Owned Business
Small Business / SBA Certified
Small Disadvantaged Business
Veteran Owned Business
Woman-Owned Business Enterprise

Please identify the certifying agency and applicable dates:
(MM/DD/YYYY format required)

Certifying Agency Name *This question is required.

Certification Date *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

Expiration Date *This question is required. This question requires a valid date format of MM/DD/YYYY.

calendar

1. Please attach a copy of your current certificate:

File: {{filename}} delete