Event Registration
South Mississippi Contract Procurement Center

Title of Event: HUBZone Conference - 7/25/13 Registration at 1:30 pm and conference starts at 2:00 pm.
Event Location: Lyman Community Center
Event Address: 13472 Highway 49
Event City: Gulfport
Date of Event: July 25, 2013
Start Time of Event:
End Time of Event:
 
  * Colored Fields are required
Company Name:
Attendee Name:
Physical Address:
City:
State:
Zip:
County:
Same as Physical Address:
Mailing Address:
City:
State:
Zip:
County:
Work Phone:
Fax:
Cell Phone or Pager:
E-Mail Address:
URL/Web Address:
 
If this is your company's first time to contact the South Mississippi Contract Procurement Center,
please complete the following:

Avg # of Employees (last 3 yrs):
Avg Yearly Gross Sales (last 3 yrs):
Date Business Was Established:    [YYYY-MM-DD or MM/DD/YY]
Have you previously done business with any government agency or prime contractor?
Yes No Don't Know
 
Business Ownership:
Check all that apply. (Defined as 51% owned and controlled.)
Woman-owned Minority-owned Veteran-owned
Service Disabled Veteran-owned
Business Certifications and Determinations:
Check all that apply.
Disadvantaged Business
Distressed
Certified HUBZone
Small Business
 
Generally describe or list the products or services you wish to offer to the government:
List the types of services you might want to receive from our center:
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