Form Center

Vendor Registration

2. First Name

3. Last Name

4. Email Address

5. Phone Number

7. Business Name

8. Business Industry

9. Business Certifications

   1. MBE
   2. SWaM
   3. Section 3
   4. WBE
   5. DBE

10. Do you have a Norfolk business license?

    1. Yes
    2. No

12. Please list Scope of Work and/or services your business provides:

14. Virginia Contractor's License #

15. Virginia Business Certification

16. Federal Tax ID/Employer Identification Number

18. Would you like to learn more about how to contract with the city?

    1. Yes
    2. No

Leave This Blank:


20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

* indicates a required field