Vendor Application

The Casino Queen is always looking for the highest quality vendors. If your company is interested in becoming a vendor for the Casino Queen, please fill out the form below.

Contact Name

Company Name

Address

Address (cont'd)

City

State

Zip

Phone

Additional Information

Minority Owned?
Yes No

Woman Owned?
Yes No

Disability?
Yes No

Casino References?
Yes No

If Yes, please list casino references

Vendor Type

Additional Comments

Any personal information collected will be kept confidential. Please refer to the Casino Queen Privacy Policy for more information.

Vendor Application

Purchasing Department

Where Loose Means Rewards