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Add Profile Details
Email Address
Email Address (confirm)
Password
Password (confirm)
First Name
Last Name
Street
City
State/Province
AL - Alabama
AK - Alaska
AB - Alberta
AS - American Samoa
AZ - Arizona
AR - Arkansas
BC - British Columbia
CA - California
CO - Colorado
CT - Connecticut
DE - Delaware
DC - District of Columbia
FM - Federated States of Micronesia
FL - Florida
GA - Georgia
GU - Guam
HI - Hawaii
ID - Idaho
IL - Illinois
IN - Indiana
IA - Iowa
KS - Kansas
KY - Kentucky
LA - Louisiana
ME - Maine
MB - Manitoba
MH - Marshall Islands
MD - Maryland
MA - Massachusetts
MI - Michigan
MN - Minnesota
MS - Mississippi
MO - Missouri
MT - Montana
NE - Nebraska
NV - Nevada
NB - New Brunswick
NH - New Hampshire
NJ - New Jersey
NM - New Mexico
NY - New York
NL - Newfoundland/Labrador
NC - North Carolina
ND - North Dakota
MP - Northern Mariana Islands
NT - Northwest Territories
NS - Nova Scotia
NU - Nunavut
OH - Ohio
ON - Ontario
OK - Oklahoma
OR - Oregon
PW - Palau
PA - Pennsylvania
PE - Prince Edward Island
PR - Puerto Rico
QC - Québec
RI - Rhode Island
SK - Saskatchewan
SC - South Carolina
SD - South Dakota
TN - Tennessee
TX - Texas
UT - Utah
VT - Vermont
VI - Virgin Islands
VA - Virginia
WA - Washington
WV - West Virginia
WI - Wisconsin
WY - Wyoming
YT - Yukon
Country
US - United States
AI - Anguilla
AR - Argentina
AU - Australia
AT - Austria
BE - Belgium
BR - Brazil
CA - Canada
CL - Chile
CN - China
CR - Costa Rica
DK - Denmark
DO - Dominican Republic
EC - Ecuador
FI - Finland
FR - France
DE - Germany
GR - Greece
HK - Hong Kong
IS - Iceland
IN - India
IE - Ireland
IL - Israel
IT - Italy
JM - Jamaica
JP - Japan
LU - Luxembourg
MY - Malaysia
MX - Mexico
MC - Monaco
NL - Netherlands
NZ - New Zealand
NO - Norway
PT - Portugal
SG - Singapore
KR - South Korea
ES - Spain
SE - Sweden
CH - Switzerland
TW - Taiwan
TH - Thailand
TR - Turkey
GB - United Kingdom
UY - Uruguay
VE - Venezuela
Zip Code
Home Phone
Work Phone
Cell Phone
Fax
How did you hear about us?
(Only one referral source will be accepted, Shoppers will be accepted over Businesses.)
Business
or
Shopper Name
Shopper Email
Comments
Add Demographics: Personal
Birthday (YYYY-MM-DD)
Gender
Male
Female
Race
Caucasian
African-American
Hispanic
Asian
Other
Refuse
Marital Status
Single
Married
Spouse Name
Highest Education
High School
Partial College
College
Post Graduage
Occupation
Professional
Retail
Sales
Homemaker
Manufacturing/Skilled Labor
Student
Retired
Unemployed
Other
Occupation if Other
Driver's License
Yes
No
Other Licenses
(i.e. Real Estate, Broker, CPA, etc)
Availability
Anytime
Days
Evenings
Weekends
List Cities you can shop in (one per line)
Add Demographics: Family
Annual Household Income
<$18,000
$18,000-$24,999
$25,000-$34,999
$35,000-$54,999
$55,000-$74,999
$75,000-$99,999
$100,000+
Refuse
Average monthly Fast Food visits
Average monthly Family Restaurant visits
Children at Home
0-5 Years Old
6-12 Years Old
13-18 Years Old
Pets
Dog
Cat
Clothing Sizes
Small
Medium
Large
Extra Large
Cars in Household
Audi
BMW
Buick
Cadillac
Chevrolet
Chrysler
Dodge
Ford
Geo
GMC
Honda
Infiniti
Jeep
Lexus
Lincoln
Mazda
Mercedes
Mercury
Mitsubishi
Nissan
Oldsmobile
Pontiac
Saab
Saturn
Toyota
Volkswagen
Volvo
Other
Add Demographics: Shopping
Shopping Experience
Retail Stores
Apartments
Automotive
Restaurants
Banks
Other
Shopping Certifications
I wear Prescription Eye Wear
Yes
No
I Own a Digital Camera
Yes
No
I Own a Computer
Yes
No
Computer Types
Windows Compatible
Macintosh Compatible
Other
Areas of Interest
I am interested in Merchandising
I have Merchandising Experience
I am Interested in Demonstration work
I have Demonstration Experience
By submiting this application for The National Mystery Shopper Directory by SELECT A SHOPPER, I verify that the information I have provided is accurate and I understand and agree to the following terms and conditions:
I give permission for any and all information provided on this application to be published in The National Mystery Shopper Directory. I understand this publication will be exclusively distributed to companies that hire mystery shoppers, merchandisers and demonstration workers, and I will be listed as a qualified shopper for use by any of these firms.
I am an independent contractor, not employed or retained in any means by SELECT A SHOPPER. I do not have any obligations to accept assignments from any companies that contact me due to my listing in The National Mystery Shopper Directory, unless I choose to do so based on my own agreement with such companies. Any assignment accepted by me will be fully and diligently completed as agreed upon unless other arrangements are agreed upon with the subscriber.
My payment/reimbursement for any assignment is the sole responsibility of the company which
contracts the assignment(s) and is not the responsibility of SELECT A SHOPPER, the publisher of The National Mystery Shopper Directory. The publisher is not responsible for any occurence related to work contracted through a listing in The National Mystery Shopper Directory. As is the case in any form of advertising, the fees for the listing in SelectAShopper are non-refundable.
My one-time fee is payment for a personal listing in The National Mystery Shopper Directory. Inclusion in the directory does not guarantee immediate work. Assignments are determined by companies that receive the directory. I am required to update my listing if changes occur. I may be removed without refund if I am unable to be contacted with the info listed.
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