Thank you for your interest in doing business with Newell Rubbermaid and its divisions. In order for our purchasing organization to possibly evaluate your potential as a supplier to our company, the following information must be submitted:
Company Information
Company's full legal name: *
Headquarters' street address: *	Suite or P.O. box:
City: *	State: *
Country: *	Zip: *
Nearest major city: *
Company Web site address (URL): *
Company contact: *
Company contact title: *
Company contact phone number: *
Company contact e-mail address: *
Please provide a detailed description of your product/service: *
Key Information
U.S. Federal Tax ID number: *
DUNS number:
Primary product/service: *	- Select Primary Product - Admin & Services Components IT Marketing Metals MRO Packaging Resin Travel Other
Please list parent company if you are an affiliate or division of another company:
Is your business international in scope?
Yes No
Last full calendar year gross sales in U.S. dollars:
Are you currently doing business with Newell Rubbermaid or any of its divisions or subsidiaries? *
YesNo
If "Yes," please list division of Newell Rubbermaid with which you are currently doing business: *
Newell Rubbermaid (division) internal contact: *
Diversity Information
Firms can be certified as diverse business enterprises if they are for-profit, physically located in the United States and at least 51 percent owned and controlled by a member of a diverse group.
Please select the diverse group to which your company belongs:
- Select Diverse Group - African American (MBE) Asian-Indian American (MBE) Asian-Pacific American (MBE) Disabled Business Enterprise (DBE) Disabled Veteran Business Enterprise (DVBE) Hispanic American (MBE) Historically Underutilized Business (HUBZone) Lesbian, Gay, Bisexual and Transgender (LGBT) Minority and Woman-Owned Business Enterprise (MWBE) Native American (MBE) Small Business Association 8(a) Business Development Program Service Disabled Veteran Business Enterprise (SDVBE) Small Disadvantaged Business (SDB) Veteran-Owned Business Enterprise (VBE) Women's Business Enterprise (WBE)
Certification
Is your business presently certified as a Diverse Supplier by National Minority Supplier Development Council (or local affiliate), Women's Business Enterprise National Council (or local affiliate), U.S. Pan Asian American Chamber of Commerce (or regional affiliate), National Women Business Owners Corporation, or Small Business Administration for its 8(a) or Small Disadvantaged Business program? *
YesNo
If your company is certified by one or more of the organizations above, please enter the appropriate information and upload your certificate below.
If your company is not certified, please visit www.sba.gov for more information.
Certification Type: *	- Select Certification Type - Disadvantaged Business Enterprise (DBE) Historically Underutilized Business Enterprise (HUBZONE) Minority & Woman-Owned Business Enterprise (MWBE) Minority-Owned Business Enterprise (MBE) SBA 8(A) Program (8(A)) Small Disadvantaged Business Enterprise (SDB) Woman-Owned Business Enterprise (WBE) Other
If "Other," please specify:
Certifying Agency: *	- Select Certification Type - NMSDC SBA WBENC Other
If "Other," please specify:
Certification Number: *
Expiration Date: *	(MM/DD/YYYY)
Upload Certificate: *

Once again, we thank you for your interest in Newell Rubbermaid. Upon submission of all required data, your company may be contacted by Newell Rubbermaid purchasing if we believe there is an appropriate opportunity for our companies to work together.