Arkansas's Business Emergency Listing (ABEL)

Please provide your registration information. Required fields are marked with an asterisk (*)

* This registration is a:
* Business Name:
Federal ID #:
* Are you a registered vendor in the state of Arkansas?

Yes No

* AASIS vendor # :

Primary Contact * First Name:
* Last Name:
* Telephone Number:
Mobile Telephone Number:
Fax Number:
* Email Address:

Secondary Contact First Name:
Last Name:
Telephone Number:
Mobile Telephone Number:
Fax Number:
Email Address:

Business Location * Street Address 1:
Street Address 2:
* City:
* State:
* ZIP Code:

Number of Years in Business:

Available Commodities/Services * Category
* Commodity/Service

* Parts of The State You Can Provide Service: Click Here to View Regional Map

Central
Northeast
Northwest
Southeast
Southwest

* Availability of Services After Activation of State Declared Emergency:
(this will depend on the location of the activated emergency)

Immediate
Within

Minority Business Certification Number (if applicable):

* Business License Number: State:
* Insurance Carrier (name only):
Misc. Notes: