Submission Form

Please complete this form for consideration of a scheduled meeting with Department of Veterans Affairs and Defense Logistics Agency prime vendors on June 5, 2018 from 1400-1700.

To participate:
1. Must be registered for the Medical, Biomedical & Biodefense: Support to the Warfighter Symposium on June 6th.
2. Complete the below form.
3. Receive an email confirmation from Courtney Smedick with a scheduled appointment timeframe (not the submission confirmation email that you will receive once you click submit on this form).

Company Name
POC First Name
POC Last Name:
Email:
Title:
Company Information
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Web Site
What year was your company established?
Which category best describes your company?

Which category best describes your company? Medical Services and Staffing Medical Supplies Pharmaceuticals Medical Devices Medical Equipment Medical Research and Development Biodefense/Biotechnologies Healthcare Information Technology
Company Description, Experience, Past Performance
Does your company currently (or previously) hold a federal or DoD contract? If so, please provide details.
Company Designation

Company Designation Small Business SBA - Certified 8(a) Self-Certified Small Disadvantaged Business SBA-Certified HUBZone Service Disabled Veteran-Owned Small Business (SDVOSB) Veteran-Owned Small Business (VOSB) Women-Owned Small Business (WOSB) Economically Disadvantaged Women-Owned Small Business (EDWOSB) Minority-Owned Business None of the above
Primary NAICS Codes
Are you registered in SAM?
Are you registered in MatchForce?

Submission Form

Submission Form

Company Information