Shopper/Independent Contractor Application
Thank you for your interest in working with Test Track Research! Please complete and submit the Shopper/Independent Contractor Application below. After submitting your application, you will be contacted via email or phone when assignments are available in your area. Required fields are indicated by an asterisk (*). All other fields are optional, however, the more information you provide the better we will be able to assign specific jobs.  

 

*First Name:
 *Last Name:
*Street Address:
Address2 
*City/Town
*State/Province:
Country 
*Zip Code:
*Home Phone #:
  Fax #
Work Phone #:
 Cell/Pager
Work Extension#: 
*Primary Email Address:
Secondary Email Address: 
*Date of Birth: (mm/dd/yyyy)
   
Demographic Information - *indicates required field
*Gender:
 Male Female
Race:
 Specify Other
Total Annual Household Income: 
Highest Level of Education: 
Primary Language:
 Specify Other:
Secondary Language:
 Specify Other:
Do you have a car? 
 Yes No
   
Miscellaneous Information - *indicates required field
       
When are you available to shop? (Check all that apply)
Daytime (6am-5pm) 
Weekdays 
Evening (5pm-10pm) 
Weekends 
Late Night (10pm-6am) 
    
Weekdays
Do you have a laptop computer? 
 Yes No    
Do you have a digital camera? 
 Yes No    
Do you have a scanner?
 Yes No    
Do you have a printer? 
 Yes No    
       
Please select which programs you currently have on your own computer, or have access to.
Programs-Word 
 Programs-Powerpoint 
WordPerfect
 WinZip 
Microsoft Excel
 Adobe Acrobat Reader 
Which type of computer do you use?
PC
  Macintosh (Apple)
Previous Experience - * indicates required field
 
*Do you have previous mystery shopping experience?
 Yes No
 
# of Years Experience Mystery Shopping:
Mystery Shopping Companies you have worked for in the past year - Please name up to 3 companies
Company #1
Company #2
Company #3
What other types of research have you done before?
Interviewing 
 Merchandising
Distribution Checks 
Store Audits 
Store Audits
Are you willing to perform projects involving...
Alcohol? 
 Yes No    
Cigarettes?
 Yes No    
Bars or nightclubs?
 Yes No    
   
*Areas you are willing to cover - Please enter the names of the cities or zip codes you are willing to cover.
Area1 
Area9 
Area2 
Area10
Area3 
Area11
Area4 
Area12
Area5 
Area13
Area6 
Area14
Area7 
Area15 
Area8 
    

Before you can submit your application, you must read and agree to the terms and conditions outlined in Independent Contractor Agreement shown below.

Do you accept the terms and conditions as outlined in the above Independent Contractor Agreement? (*Note: You must accept the Independent Contractor Agreement before you can submit your application.)

Yes, I accept.

No, I do not accept.

   
 Test Track Research - The truth from the trenches.©
 147 Columbia Turnpike, Suite 303 - Florham Park, NJ 07932 - Phone: (973) 360-1660 - Fax: (973) 360-1667 - Email: info@testtrackresearch.com