Sample Approved/Preferred Vendor Application Form
Company Name ______________________________________________________	
Address	__________________________________________________________ 
City/State/Zip ________________________________________________________ 
Phone ____________________________  Fax _____________________________
CEO Name ________________________  CEO Title __________________________
CEO E-mail _______________________   CEO Phone _________________________  
Marketing E-mail ___________________
Social Security Number _______________ Name of SSN Owner ___________________
Federal Tax ID Number _______________

----------------------- COMPANY INFORMATION -----------------------
Organization Type:     Sole Owner ___	Corporation ___		S-Corp. ___
State of Incorporation? ______________________ 	Nonprofit? ___Yes     ___No
Other Socioeconomic Factor(s)? ___________________________________________
Domestic/Foreign Owned? _______________________________________________
Is your company owned by a parent company? ___Yes     ___No
Parent Company Name _________________________________________________
Parent Company Address ________________________________________________
Parent Company Tax ID ________________________
Are you:	 Small Business? ___  Minority-Owned Business? ___  Veteran-Owned
Business? ___  Women-Owned Business? ___  Veteran Disabled-Owned Business? ___
Other Socioeconomic Factor(s)? ___________________________________________
Certifications:  8a Certified? ___  Minority? ___  Women-Owned? ___  HUBZone? ___
Mentor Program:	Mentor Company ________________________________________
Contact Information ___________________  Phone Number _____________________
Does your company accept credit cards?  ___Yes     ___No			
Primary Standard Industrial Code __________________________________________
Additional SICs _______________________________________________________
Primary North American Industry Classification System Code (NAICS) _______________
Additional NAICSs _____________________________________________________
Products/Services (short narrative): _________________________________________
_________________________________________________________________
_________________________________________________________________
Company’s Web Site(s): _________________________________________________
FSCM/Cage Code  _____________________________________________________
Registered CCR?    ___Yes     ___No	         Registered Pro-Net?     ___Yes     ___No
Did your company have a name change in the past 12 months?     ___Yes     ___No
Name _____________________________________________________________
Company Contact _________________  Quality Assurance Contact _________________

----------------------- GENERAL INFORMATION -----------------------
Area in Sq. Ft.:  Manufacturing ____  	Office _____  	Total _____
Number of Personnel:  Manufacturing _____	 Quality Assurance ____  Engineering _____
Are clean room facilities used for manufacturing product? ____	Yes____	No
What percentage of present work is:  Government ____  Commercial ____  Other ____
Describe any special processes that you perform (e.g., plating, painting, soldering, welding, wire wrap, etc.). _____ ________________________________________________________________
_________________________________________________________________
Are you ISO-9000 certified? ___Yes     ___No        ISO Certificate Type _______________
Registrar _______________________	Certificate Number ___________________
Expiration Date: ISO READY/Not Certified ________     Date of Certification ___________
Registered or certified to any other Quality Management System or model? 
_________ Mil-I-45208    __________ Mil-Q-9858    ____________ Other

----------------------- QUALITY MANAGEMENT SYSTEM -----------------------
Do you maintain operation policies and procedures for your quality management system? ___Yes     ___No
Is an internal audit program maintained that reviews compliance with all aspects of the quality program? ___Yes     ___No
Does the organizational structure define quality responsibility and authority? ___Yes     ___No
Does the organizational structure provide access to top management? ___Yes     ___No
Is the health and status of your quality management system periodically reviewed with management? ___Yes     ___No
Do you have a documented employee training program? ___Yes     ___No
Is the quality organization responsible for acceptance of product and services? ___Yes     ___No
Are records of inspections and tests maintained? ___Yes     ___No
Are quality data used in reporting results and trends to management? ___Yes     ___No
Are quality records available to support customer certifications? ___Yes     ___No

----------------------- DESIGN INFORMATION -----------------------
Do procedures cover the release, change,  and recall of design and manufacturing information, including correlation of customer specification? ___Yes     ___No
Do records reflect the incorporation of changes? ___Yes     ___No
Does quality control verify that changes are incorporated at the effective points? ___Yes     ___No
Is the control of design and manufacturing information applied to the procurement activity? ___Yes     ___No
Is there a formal deviation procedure? ___Yes     ___No

----------------------- PROCUREMENT CONTROL -----------------------
Are procurement sources evaluated and monitored? ___Yes     ___No
Are quality requirements and inspection procedures specified? ___Yes     ___No
Is a documented system maintained for the evaluation of purchased materials? ___Yes     ___No
Are incoming materials identified and segregated until acceptance? ___Yes     ___No

----------------------- MATERIAL CONTROL -----------------------
Do procedures exist for storage, release, and movement of material? ___Yes     ___No
Are materials in storage identified and controlled? ___Yes     ___No
Are in-process materials identified and controlled? ___Yes     ___No
Are materials inspections identified and controlled? ___Yes     ___No
Do storage areas and facilities provide control to protect material from degradation? ___Yes     ___No
Do you have an electrostatic sensitive device protection program? ___Yes     ___No
Are nonconforming items identified, segregated, and controlled? ___Yes     ___No
If required, do you have the ability to provide tractability? ___Yes     ___No