Username:
If you don't enter your username,
it WILL be set to your email address.
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| Password * : | |
| Confirm password * : | |
| First Name * : | |
| Last Name * : | |
| Email * : | |
| Do you wish to subscribe to our newsletter? | Yes
No
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| Address * : | |
| Address 2: | |
| City * : | |
State * :
Select Non-US if in Canada. | |
| Province (if Non-US): | |
| Postal code * : | |
| Country * : | |
| Daytime phone * : (xxx-xxx-xxxx) | |
| Evening phone * : (xxx-xxx-xxxx) | |
| Available for Emergencies: | Yes
No
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Cities where you are available to work * :
Once you have entered your complete address above, click
the SELECT button to the right. A popup box will appear with
all cities in your state that have 2,500 residents or more.
Select the ones you can work in. If you do not see a city you
can work in, type it in the box, to the right, instead. | |
| Cell phone: (xxx-xxx-xxxx) | |
| Fax: (xxx-xxx-xxxx) | |
| Gender: | Male
Female
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Birth date *
(MM/DD/YYYY): | |
| Race: | |
| Languages you speak fluently * : | Arabic
English
French
French/Canadian
German
Spanish
Russian
Other
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| What other language(s) do you speak: |
| Certifications you hold: | |
| Although the fields below are NOT required, this information will help us match your demographic with client requirements. |
Mystery Shopping Experience:
To select more than one type of experience you
MUST hold down the CTRL key on your keyboard
and use your mouse to select the types of
experience you have. | Select Those That Apply
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Other Experience:
To select more than one type of experience you
MUST hold down the CTRL key on your keyboard
and use your mouse to select the types of
experience you have.
| Select Those That Apply
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| Height: | |
| Hair Color: | |
| Do you wear glasses?: | Yes
No
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| Martial Status: | |
| Level of Education: |
If Other, describe here:
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Combined Household Income:
(example $35,000) | |
| Social Security Number: | |
| Would you prefer to receive payment through your PayPal account?: | Yes
No
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| If yes, PayPal Account email address: | |
Please select the equipment to have available to
use on your shops: | Digital Camera
Laptop Computer
Video Camera
Digital Recorder
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Are you available to travel outside your immediate area,
provided
expenses and/or mileage are paid? | Yes
No
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| Do you own or have access to use (view AND edit documents) in: | MicroSoft Word
Yes
No
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MicroSoft Excel
Yes
No
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| Click here to view the Independent Contractor "Shopper" Agreement.
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I certify that I have read and agree to the terms
of the Independent Contractor "Shopper" Agreement. |
Membership type: |
free |
| * - Required fields |
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