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Vendor Certification Form with Categories

  1. W-9 Fax Instructions

    The W-9 Form is required to be considered as a vendor. If you are unable to attach your company's W-9 to this form, please fax it to the Procurement Department at 662-469-8262.

  2. Is a credit application required?*

  3. Your Company Provides:*

  4. Categories

    Check each category of product or service that your company provides.

  5. A

  6. B

  7. C

  8. D

  9. E

  10. F

  11. G

  12. H

  13. I

  14. J-L

  15. M-0

  16. P

  17. R

  18. S

  19. T

  20. U-Z

  21. Leave This Blank: