My business is minority/woman owned...

Full Name
Company Name
Telephone Number
Email Address

Are you a business owner? Yes No

Does minorities or women ownership total 51% or more of your company? Yes No

Is your company certified as a minority, woman, or disadvantaged company? Yes No

What type of certification? (i.e., minority, women, disadvantaged company)

Which agency provided the certification? (i.e. NV Minority Business Council, NDOT, NSBDC)

If not certified, would you want to be certified? Yes No

What year was the company established?

What is the diverse owner(s) percentage of involvement of daily operations? 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Does your company currently service the gaming industry? Yes No

What are your primary products and/or services?

Explain more about the products and/or services that your company provides?