Self Declaration Please review your entries before submitting and self-declaring. You are unauthorized to view this page. Username Password Remember Me Forgot Password Name(Required) First Last Job Title(Required) Company Name(Required) Email(Required) Phone(Required)Self-Declaration of Diversity Qualifications(Required) I Acknowledge/AgreeBy clicking the box and signing, you hereby acknowledge, agree and declare that you represent an alcohol beverage supplier or brand (“Company”) that (i) has diverse owners (a diverse person(s) must be the majority owner(s) (at least 51% ownership) and must have management and control of the company); (ii) is diverse-led (at least 51% of C-Suite and Senior Executive positions are held by diverse person(s). Diverse Powered Brands classifies these roles as titles beginning with “Chief” and titles that include, General Manager, Board Member, Managing Director, President and/or Vice President.); or (iii) is diverse-made (maker of the brand must be a diverse person in a senior leadership role overseeing the day-to-day production of the brand, such as head distiller, master distiller, master blender, master taster, head winemaker, lead brewer, master brewer, and/or lead viticulturist/grower). For the purpose of this declaration, “diverse” includes BIPOC, Disabled, LGBTQIA+, Veteran, and Women. You further acknowledge and agree, on behalf of your Company, that: i. To the best of Company’s understanding after reasonable inquiry, the statements and information presented by Company on this Website (collectively, “Company Information”) are true, accurate and complete. The Company has all the rights necessary to grant Diverse Powered Brands (“DPB”) the use of Company Information on the Website and that use of Company Information by DPB does not violate any law; ii. For any natural person referred to, or otherwise depicted by Company on the Website, Company maintains and grants all the necessary rights and permission for DPB to use such person’s name, likeness, image, voice, biographical information, statements, performance and/or testimonial(s) on the Website; iii. Company shall indemnify, defend and hold harmless DPB and its officers, representatives, agents, employees, successors and assigns from and against any and all claims arising directly or indirectly from the inclusion of Company Information on the Website; iv. DPB reserves the right to remove Company Information from the Website if Company fails to declare Company Information is true, accurate and complete on an annual basis or as required by DPB. v. Company agrees to re-declare Information is correct and accurate on an annual basis; and vi. If Company Ownership, Brand Leadership and/or Brand Maker changes anytime within the year prior to annual renewal, Company must login and update this information within 30 days and sign and resubmit Self-Declaration form for approval.Consent(Required) Have Read and Agree to the Terms of UseSignature(Required) Reset signature Signature locked. Reset to sign again