Vendor Form

Thank you for your interest in doing business with the Golden Nugget.

We are always interested in adding to our vendor base. Please fill out the following form with information about your business and we will contact you if there is an opportunity for us to work together. We look forward to the possibility of working with you.

Note: Completing this form does not constitute an offer of business or award to any company.

* Required Information

Correct the following errors:

If you can see this field, leave it blank:
Company Information
Area of Interest *
Business Structure *
Company Name (Legal/DBA/Division of) *
Address *
Address (Cont.)
City *
State *
Zip Code *
Vendor Contact Information
Vendor Contact Person *
Telephone Number *
Fax Number
E-mail Address *
Primary Owner Information
Primary Owner Name
Primary Owner Title
Percentage Ownership
%
Diversity Status
Business Details
Do you have an office or distribution center in Louisiana?

Is your primary business gaming?

Business Type
Please select the primary type of products and services that your company provides
Please select up to 5 additional products or services you may provide (Hold down control to select more than one item from the list)
If you would like to upload a document to showcase your company you can do so here. (up to 8MB)