Supplier Diversity Growth Capital: Self Assessment

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This form captures preliminary information for a business seeking to participate in this initiative. Before proceeding, LISC recommends that respondents read the online FAQ for more information.

Have you read the FAQ and do you reasonably believe you qualify for this program?

YesNoReading the FAQ is a requirement of this initiative. If you select 'No', you will not be able to proceed.

Structure of Business

Is your business registered in the United States?

YesNo

Do you have a pending procurement or vendor contract that you are currently unable to fulfill?

YesNo

Do you and your business identify as any of the following: (where ownership is based on 51% ownership or more)?

Disability-Owned Business EnterpriseLGBTQ+ Owned Business EnterpriseMinority-Owned Business EnterpriseVeteran-Owned Business EnterpriseWoman-Owned Business EnterpriseNone of the Above

Are you a certified Disability-Owned, LGBTQ+ Owned, Minority-Owned, Veteran-Owned, and/or Woman-Owned Business Enterprise (where ownership is based on 51% ownership or more)?

YesNo

Self-Assessment Score:

Max score: 5 points

Thank you for your interest in this initiative. Click ‘Submit’ below to complete your entry.

Please note: you will not be able to update your responses once you click ‘Submit’.

Self-Assessment Initiative

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