2nd Tier Reporting System - Prime Supplier Registration

Welcome to the ConocoPhillips Supplier Diversity 2nd Tier Reporting System. If you are a ConocoPhillips Prime Supplier and you have not yet registered to report 2nd Tier Diverse Spend, please complete this form. Upon submission of your registration, you will receive additional information via email.

Required fields are noted with an asterisk.

Prime Supplier Company Information
Company:
Address:
   Address Cont.:
City:
Country:
State/Region:
Zip:
 
Prime Supplier Contact Information
User:
Contact Name:
   Title:
Phone Number:
   Fax Number:
E-Mail Address:
ConocoPhillips Contact Information
Contact at ConocoPhillips:
   Contact Phone Number:
Contact E-Mail Address:
MBE Goal (%):  (%)
WBE Goal (%):  (%)