Mystery Shopper Application Form | InvestigationsAmerica.com

Section 1 : Account Information

Desired Login Name*
Password*
Confirm Password*

Section 2 : Contact Information

First Name*	Initial	Last Name*	Suffux
Address Line 1*
Address Line 2

City*

State*

Postal Code*

Home Email*	Confirm Email*
Work Email	Confirm Email
Home Phone*	Work Phone	Please make sure to include your area code!
Home Fax	Work Fax	Please make sure to include your area code!

May we occasionally contact you at work?*

Investigations America requires shoppers to provide a way that they can be reached promptly if there are issues with a shop in progress.
Do You:
	Have voice mail or an answering machine that you check regularly?
	Check your email at least once daily?
	Remain consistently available at the phone number you provided?
	Have a number, such as a mobile phone or pager, at which you can be reached?	If YES, please provide

Section 3 : Employment/Referral Information

Current Occupation*
Current Employer*
Work History (Please enter five year history of employers)*
How did you hear about Investigations America?
Please briefly tell us why you would be a good representative for Investigations America

	Name	Phone	Email

Please provide 3 personal references*

Are you currently performing, or have you previously performed shopping or consumer research for any other company?

If YES, please list for whom and when in the area below

Section 4 : Demographics and Assignment Preferences

Investigations America is an Equal Opportunity Employer. As a market research company, Investigations America is sometimes required to match the personal profiles of our independent contractors with the average target market of our clients. Investigations America also uses demographic information to perform diversity shops and statistical analysis at our clients' request.

Answering demographic and preference information may qualify you for additional shops. Failing to answer these questions may preclude you from being offered certain shops. Please help us get to know you better by completing the following information.

Race*	Gender*	Birth Date*
Marital Status*	Household Income*	Education

Number of children in your household:

Under 15 years old*
15 years or older*
Children live in household more than 6 months per year?*

Do you have:
Glasses?
Pets?
An automobile?
Are you:
A vegetarian?

Are you willing to perform mystery shops:
Where purchase of an alcoholic beverage is required?
Where you would dine seated at the bar?
During the late evening or early morning hours?
In a smoky restaurant or bar?
Where small children cannot be brought along?

How many miles are you willing to travel to perform a shop?

Section 5 : Acknowledgment

I certify that the information provided in this application is correct, and acknowledge that I can be disqualified as a Investigations America shopper for presenting false application information.

Yes, I agree No, I refuse

Welcome to the Mystery Shopper Application Form!

Section 1 : Account Information

Section 2 : Contact Information

Section 3 : Employment/Referral Information

Section 4 : Demographics and Assignment Preferences

Section 5 : Acknowledgment