Office of Equal Business Opportunity

Vendor Registration Form

Company Name: *This question is required.

Contact Person:
First Name *This question is required.

Contact Person:
Last Name *This question is required.

Contact Person's Title:

Company Website

Street Address

City

State

Zip

Email Address *This question is required. This question requires a valid email address.

Phone Number

Are you registered with Palm Beach County?

Are you registered with the Office of Equal Business Opportunity?

E-mail Disclaimer:

Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.