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Kohl's Suppliers
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Supplier Registration Form
*Required fields.
Company Address
Name of Company: *

Address: *

City: *

State: *
ZIP: *
Phone: *

Fax: *

Website:
Company Information
Business Entity Type: *
Company Ownership: *
Federal ID: *
D & B DUNS: *
Year Established: *
# of Employees: *
Annual Sales:
2006
2005
2004
2003
Contact Information
Contact Name: *
Title: *
Address: *
City: *
State: *
ZIP: *
Phone: *

Fax: *

E-mail: *
References
Company Name:
Contact Name:
Phone Number:

Product/Service Provided:
Largest Contract to Date :
   
Company Name:
Contact Name:
Phone Number:

Product/Service Provided:
Largest Contract to Date :
   
Company Name:
Contact Name:
Phone Number:

Product/Service Provided:
Largest Contract to Date :
Diversity Information *
Would you like Kohl's to know your business is minority- and/or women-owned as identified by the National Minority Supplier Development Council (or local affiliate) and/or Women's Business Enterprise National Council? Diversity status will not affect bid opportunities.
Yes No
If no, please continue to the Description of Product(s) or Service(s) section.
If yes, please complete the Agency Certification Information.
   
Agency Certification Type (1):
Minority Status:
Agency Certification Number:
Expiration Date:
   
Agency Certification Type (2):
Minority Status:
Agency Certification Number:
Expiration Date:
   
Description of Product(s) or Service(s)
If you can provide multiple good/services, please list in the Description of Product(s) or (Service(s) field below.
Commodity Group: *
Commodity Code: *
Geographical Service Area: *
   
NAICS Code(s) and Title(s)
Primary NAICS Code:
Additional NAICS Codes:


Primary U.S. NAICS Title:
Additional U.S. NAICS Titles: