Kinston Teens - Vendor Registration

Name *

First Name

Last Name

Type of Business *

Individual/Sole Proprietorship

Corporation

Partnership

Nonprofit

Other

Phone

(###)

###

####

Physical Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mailing Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Preferred Payment Method *

If ACH or Cash App, we will follow-up to request additional information.

Check

ACH

Cash App

Please check any that apply:

This is optional demographic information to help us track the type of business partners we work with.

Woman-owned business

Veteran-owned business

Small business (less than 25 employees)

Black-owned business

Minority-owned business

Solo entrepreneur/Independent Contractor/Sole Proprietorship

Youth-owned business (Primary owner is 24 years old or younger)