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Kansas Minority Enterprise Development
(MED) Week 2021

Minority- and Woman-Owned Business of the Year Nominee Form

  • BUSINESS INFORMATION

  • A) Provide background information about the business and owner(s). (45 points maximum)

  • Owner's NameTitlePercentage OwnedEthnicityGender 
  • B) Describe the current financial condition of the business by providing the following information. (35 points maximum)

  • Please select the amount that closely reflects the total average gross receipts.
  • For Fiscal Year 2021
  • For Fiscal Year 2020
  • For Fiscal Year 2019
  • Drop files here or
    Max. file size: 300 MB.
    • Drop files here or
      Max. file size: 300 MB.
      • Request your State of Kansas Tax Clearance Form

      • If your tax clearance form is unavailable at the time of submission, please email the completed form to Office of Minority and Women Business Development: kdc_mwbd@ks.gov
        Max. file size: 300 MB.