TEST - The Bridge 2 Technology

* Required Fields

Contact Name*

First Last

Email Address*

Phone Number*

Are you interested in providing or seeking opportunities?*

Which of the following, best describes you today?*

Entrepreneur/Business Owner

Company Name*

Company Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Website*

Primary Industry*

Good and Services Provided (Please upload capabilities statement, or marketing literature, preferably in Word format)*

Drop files here or

Accepted file types: docx, xlsx, Max. file size: 50 MB, Max. files: 2.

Are you a diverse company?

Please list your top 5 customers

Please list socioeconomic certifications if applicable

(Example: Women owned, Minority Owned (specify ethnicity), Veteran, Service Disabled Veteran, HubZone)

Industry Sector:

Please list quality certifications if applicable

(Example: ISO9001; TS16949, AS9100 Level D, etc.)

Revenue range:

Choose your main activity:

Finance

Human Resource/ diversity & inclusion

Marketing/Communications

Operations/Procurement

Supplier Diversity

Sales

List the regions you currently do business in the US, Europe, Asia, and LATAM

Provide additional information about your organization

Corporation

Company Name*

Company Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Website:*

Primary Industry*

Good and Services Provided (Please upload capabilities statement, or marketing literature, preferably in Word format)*

Drop files here or

Accepted file types: docx, xlsx, Max. file size: 50 MB, Max. files: 2.

Are you a diverse company?

Please list your top 5 customers.

Please list socioeconomic certifications if applicable

(Example: Women owned, Minority Owned (specify ethnicity), Veteran, Service Disabled Veteran, HubZone)

Industry Specialization (if applicable):

Please list quality certifications if applicable

(Example: ISO9001; TS16949, AS9100 Level D, etc.)

Revenue range:

What is your primary business:

(i.e. Financial Services, Retail, Technology, Manufacturing)

List the regions you currently do business in the US, Europe, Asia, and LATAM

Provide additional information about your organization

Financial Services

Company Name*

Company Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Website:*

Primary Industry*

What type of business are you seeking?*

Please describe what kind of business or financing opportunities you are providing?**

Industry Specialization (if applicable):

Upload marketing materials preferably in Word format:

Drop files here or

Accepted file types: doc, docx, Max. file size: 50 MB, Max. files: 1.

Please list qualifications for your target audience:

Locations you are recruiting?

Provide a link to the company recruiting website if applicable

What makes your firm unique/source competitive advantage?

List the regions you currently do business in the US, Europe, Asia, and LATAM

Provide additional information about your organization

Recruiter, Human Resources

Company Name*

Company Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Website*

Primary Industry*

What type of personnel are you looking for?*

Please upload recruiting materials, etc. preferably in Word format

Drop files here or

Accepted file types: doc, docx, xlsx, Max. file size: 50 MB, Max. files: 2.

Industry Specialization (if applicable):

Please list qualifications for roles in your firm

Locations recruiting for?

Provide link to company recruiting website if applicable

What makes your firm unique/source competitive advantage?

Any additional information you'd like to add

List the regions you currently do business in the US, Europe, Asia, and LATAM

Provide additional information about your organization

Non-Profit Leaders and Educators

Organization Name*

Organization Phone*

Title*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Area of Specialization

Programs and service offerings (for non-profits – upload preferably in Word format if applicable)*

Drop files here or

Accepted file types: doc, docx, xlsx, Max. file size: 20 MB, Max. files: 1.

Geographic Area served (if applicable)

List the regions you currently do business in the US, Europe, Asia, and LATAM

Provide additional information about your organization

Government Agency, Public Entity

Organization Name*

Organization Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Geographic Area served*

List the regions you currently do business in the US, Europe, Asia, and LATAM

Provide additional information about your organization

Other

Organization Name*

Organization Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Primary industry:*

Industry specialization:

Website:

What is your primary business?

(i.e., Financial Services, Retail, Technology, Manufacturing)

List the regions you currently do business in the US, Europe, Asia, and LATAM

Provide additional information about your organization

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