Imation - Supplier Registration

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Supplier Registration Form

Please complete the following form to register with Imation as a potential supplier. This information will be reviewed by the appropriate Commodity Manager for potential opportunities.

You do not need to apply more than once. Unless you ask us to remove your information, your application will remain in our database for future consideration.

First Name *

Last Name *

Company *

Address 1 *

Address 2

Address3

City *

State/Province *

Other

ZIP/Postal Code *

Country *

Other

Phone *

E-mail *

Confirm E-mail *

Do we have your consent to store your information in the United States of America? If not, do not complete this form. * Yes

Specify your diversity
classification(s): *

Large	Disadvantaged
Small	Woman Owned
Minority	Hub Zone

What is your primary commodity category? *

Capital	Outside Processing
Finished Goods	Packaging
Hard Goods	Raw Materials
Information Technology	Semi-Finished
MRO	Services

Primary product or service you offer: *

What is the Web address of your company? *

How many employees are in your
company? *

What countries are you based in? *

What regions do you service? Check all that apply. *

Africa	Europe
Asia	Middle East
Australia	United States
Canada

I have read and accept Imation's Privacy & Terms statements. *