Application Form Certified Vendor Provider Program

For best results, please set aside time to complete this form in one sitting. Progress cannot be saved to return later.

Organization/Company Details

Date

Primary Contact Name

Title Role

This address will receive a confirmation email

Phone Number

Headquarters Address

Country

List additional headquarter locations

Company Name

Company Website

Year Founded

Which best describes your company? Please select all that apply:

Aerospace / Space Defense / Dual-Use Government / Public Sector University / Research Institution SME / Startup Prime / Tier-1 Investor / Capital Partner

Entity Type

Leadership Team Overview | Names and titles of key executives

Company/Organization Size

1–10 10–50 50–250 250-500 500+

Annual Revenue Range

Under $2M $2M–$10M $10M–$50M $50M+

Industry Focus & Capability

Please list additional team members who need access: Share their first and last names and email address

Provide a brief description of your company’s products or services.

Ideal Client Profile

What specific problems do you solve for Space Grove companies?

Years of Experience Delivering These Services

Relevant Certifications, Licenses, or Accreditations

Experience Serving (Select all that apply)

Startups Growth Stage Companies Enterprise of Government Companies

Are you properly licensed and insured to provide your services

Yes No

Have you or your company been involved in litigation, regulatory action, or sanctions within the past five years?

Yes No

If you answered YES, please explain.

Why do you want to be a Certified Vendor Provider with Space Grove?

How does your organization support innovation, workforce development, or ecosystem building? *

Are you comfortable operating as an independent third party without revenue guarantees from Space Grove?

Yes No

What in-kind benefit are you willing to provide to Space Grove participants? (Example: one consultation, workshop, discount, office hours)

Are you willing to offer at least one educational session per year (virtual or in-person)?

Yes No

Are you willing to respond to referrals or inquiries within a reasonable timeframe (for example, 3–5 business days)?

Yes No

Are you willing to comply with Space Grove branding and communication guidelines?

Yes No

Do you acknowledge that Space Grove may remove vendors at its discretion?

Yes No

I understand that acceptance as a Certified Vendor Provider does not guarantee business, revenue, contracts, or outcomes, and that Space Grove is not responsible for my engagements with third parties. Please initial to acknowledge you have read the statement.

Logistics & Visibility

Upload your logo (high resolution png or jpeg file)

Upload (8MB)

Anything else we should know to ensure a high-value experience for your organization?

Media Release Consent I grant permission for photos or video to be used for program purposes I do not grant permission Option

Partnership Agreement

Agreement to Execute the Certified Vendor Provider Agreement, if we are selected to participate in the program

Please initial if you agree to the following terms: 1. No Guarantee of Outcomes Participant acknowledges and agrees that Space Grove makes no representations, warranties, or guarantees regarding outcomes of participation in the Space Grove Certified Vendor Provider (CVP). Participation does not guarantee revenue, business development, customer acquisition, scaling opportunities, funding, contracts, partnerships, visibility, or commercial success of any kind. All business decisions and outcomes remain solely the responsibility of the Participant. ________________________________________ 2. Independent Third Parties Independent Third Parties. All Certified Vendors listed within the Space Grove Certified Vendor Provider are independent third parties. Space Grove does not control, manage, supervise, or direct the services, conduct, performance, pricing, timelines, or business practices of any Certified Provider. Any engagement between a Participant and a Certified Provider is solely between those parties. ________________________________________ 3. No Endorsement or Warranty Inclusion of a Certified Provider in the Space Grove Certified Vendor Provider program does not constitute an endorsement, guarantee, or warranty of services, outcomes, or fitness for any particular purpose. Space Grove expressly disclaims all liability related to the acts or omissions of Certified Providers. ________________________________________ 4. Assumption of Risk Assumption of Risk. Participant assumes all risks associated with engaging Certified Providers, including but not limited to financial loss, service failure, delays, disputes, or damages. Participant is solely responsible for conducting its own due diligence prior to entering into any agreement with a Certified Provider. ________________________________________ 5. Indemnification and Hold Harmless Participant agrees to indemnify, defend, and hold harmless Space Grove, its officers, directors, employees, contractors, affiliates, and representatives from and against any and all claims, damages, losses, liabilities, costs, and expenses, including reasonable attorneys’ fees, arising out of or related to: (a) Participant’s use of the Space Grove Certified Vendor Provider, (b) any engagement or dispute with a Certified Provider, or (c) Participant’s business activities, representations, or agreements with third parties. ________________________________________ 6. Limitation of Liability To the maximum extent permitted by law, Space Grove shall not be liable for any indirect, incidental, consequential, special, or punitive damages, including lost profits, lost business opportunities, or reputational harm, arising out of or related to this Agreement or participation in the Certified Vendor Provider. ________________________________________ 7. No Fiduciary Relationship Nothing in this Agreement shall be deemed to create a partnership, joint venture, fiduciary, agency, or employment relationship between Space Grove and Participant. ________________________________________ 8. Termination at Any Time Either party may terminate this Agreement at any time, with or without cause, upon written notice. Upon termination, Participant’s access to the Certified Vendor Provider and associated benefits shall immediately cease. ________________________________________ 9. Entire Agreement and Governing Law This Agreement shall be governed by and construed in accordance with the laws of the State of Florida, without regard to conflict of law principles. ________________________________________ Participant acknowledges that it has not relied on any statements, projections, representations, or assurances made by Space Grove outside of this Agreement.

Payment

Participation Fee

Please sign below to acknowledge that you understand that there is a participation fee. Annual Certified Provider Fee:

$2,500 per year, per vendor + 5% profit share on Space Grove leads

This covers:

Vetting and certification

Inclusion in the Space Grove Certified Provider Network

Visibility to member companies

Right to market themselves as "Space Grove Certified"

Participation in up to 2 Space Grove-hosted sessions annually

Listing on the website and materials

Access to member companies via opt-in introductions

Application Form Certified Vendor Provider Program

Description

Please Fix the Following