Supplier Interest Form

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Company Information

Tell us about your Company
* Company Name:
Company Website:
* Address:
* City:
* State:
* Zip:
* Company Phone:
Company Fax:

Product and/or Service Information

Tell us about your products and/or services
* Detailed Service / Product Description:
Comments (anything more that you would like us to know about your product and service offerings):

Contact Information

Who should we contact, if we determine there may be an opportunity for a business relationship?
* First Name:
* Last Name:
* Phone:
* Email:

Please disclose all known relationships you and/or your company has with any employee of Grand Canyon University or any of its subsidiaries who can influence the actions of purchasing decisions or is in a management position. In such an event, please disclose the employee’s name and the benefit/interest involved below. Additionally, if you and your company become aware of a relationship that would be considered a conflict of interest with any employee of Grand Canyon University or any of its subsidiaries, you and your company shall notify Grand Canyon University by emailing [email protected], within fifteen (15) calendar days of learning about such relationship.





By acknowledging, accepting, or making any delivery of products or services to Grand Canyon University or any of its subsidiaries, you and your company agrees to comply with and to be bound by the Supplier Code of Conduct, procedures, guidelines, policies, and terms and conditions posted on the Doing Business with Grand Canyon University webpage listed below. Any additional terms proposed shall not be binding on Grand Canyon University unless the terms have been agreed to in writing by both parties.

Please complete the following to validate your response: