Business Service Provider Application

Please complete the application below and download the instructions and payment document at http://www.buyusa.gov/kansascity/bsppayment.doc

Fields marked with * are required.

Company and Contact Information

Company name*

First name*

Last name*

Salutation  Mr. Ms. Mrs. Miss. Dr.

Title 

Company address*

City*

State* Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip code*

Phone 

Fax 

Email*

Web site 

Business Service Provider Company Information

Please select your industry category (select one)* Accounting Services Advanced Ceramics Advertising Services Agricultural Chemicals Agricultural Machinery & Eq. Agricultural Services Air Conditioning/Refrigeration Eq. Aircraft/Aircraft Parts Airport/Ground Support Eq. Apparel Architectural/Constr./Engineering SVC Artwork Audio/Visual Eq. Automobile/Light Truck/Vans Automotive Parts/Services Eq. Aviation Services Biotechnology Books/Periodicals Building Products Business Eq. (Non-Computer) Chemical Production Machinery Coal Commercial Fishing Eq. Commercial Vessel/Eq. (Non-Fisheries) Composite Materials Computer Services Computer Software Computers/Peripherals Construction Eq. Consumer Electronics Cosmetics/Toiletries Defense Industry Eq. Dental Eq. Drugs/Pharmaceuticals Economy Education/Training Services Electrical Power Systems Electronic Commerce Electronic Components Electronics Industry Prod/Test Eq. Employment Services Films/Videos Financial Services Food Processing/Packaging Eq. Foods - Processed Footwear Forestry/Woodworking Machinery Franchising Furniture General Consumer Goods General Industrial Eq./Supplies General Science & Technology General Services Giftware Health Care Services Hotel/Restaurant Eq. Household Consumer Goods Industrial Chemicals Information Services Insurance Services Investment Services Iron/Steel Jewelry Laboratory Scientific Instruments Lawn/Garden Eq. Leasing Services Leather/Fur Products Machine Tools/Metalworking Eq. Management Consulting Services Marine Fisheries Products (Seafood) Materials Handling Machinery Medical Eq. Mining Industry Eq. Musical Instruments Non-Ferrous Metals Oil/Gas Field Machinery Oil/Gas/Mineral Prod/Explor Serv. Operations/Maintenance Services Packaging Eq. Paper/Paperboard Pet Foods/Supp. Photographic Eq. Plastics Materials/Resins Plastics Production Machinery Pleasure Boats/Accessories Pollution Control Eq. Port/Shipbuilding Eq. Printing/Graphic Arts Eq. Process Controls - Industrial Pulp/Paper Machinery Pumps/Valves/Compressors Railroad Eq. Regulations Renewable Energy Eq. Robotics Security/Safety Eq. Sporting Goods/Recreational Eq. Telecommunications Eq. Telecommunications Services Textile Fabrics Textile Machinery/Eq. Textile Products - Made-Up Tools - Hand/Power Toys/Games Trade Promotion Services Transportation Serv. (other than Aviation) Travel/Tourism Services Trucks/Trailers/Buses Used/Reconditioned Eq. Veterinary Medicine Eq./Supplies Water Resources Eq./Services Yarns

Company Description for Directory Listing (limit 250 words)*

Trade References (provide at least two references of U.S. exporting companies with whom you have conducted business)*

DUNS Number 

Submission of business or personal information is voluntary. Please be aware of our Privacy Policy.