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Field Rep Application Form
       
Step 1 of 6
 
Thank you for your interest in becoming an ICCDS Field Representative.

ICCDS is a leader in the field of Mystery Shopping. Whether you have participated as a Mystery Shopper previously, or this is your first time, you'll find that Mystery Shopping is a great way to earn extra money and help your favorite companies. Many of our Mystery Shoppers have been with us for some time now, and they love it!

As you complete your application, be sure to check this space on every page for useful information that will help you answer the questions we are asking.

Your answers to these questions are used by us to match your skills with specific jobs, so take your time and answer as completely as you can.

Once your application is approved, and you are entered in to our database, you will be able to:
  • Learn about available assignments
  • Submit information for assignments you have completed
  • Communicate with us and ask questions, or just provide feedback

New features are continually added.

Ready? Let's begin with the basics. Make sure you enter all of your contact information accurately. Your contact information is entered into our system and is used to create your profile. We will be emailing you to tell you we've accepted your application. So double-check your contact information to be sure it is correct.

Occasionally, our friendly staff may contact you about terrific mystery shopping opportunities in your area. Sometimes they will contact you to discuss recently completed assignments. That's another reason why it is essential to make sure all of your information is accurate. Once you have finished answering the questions on this page, please check one final time to make sure everything is correct before you click on the Continue button.

Remember, all of your information must be accurate in order to qualify as an independent contractor with ICCDS. 		xx
YOUR NAME
First name:*
MI:
Last name:*
Gender:* Male Female
Date of Birth:*  
mm/dd/yyyy
Why we need your Birth Date
EMail Address:*
 
Confirm Address:*
 
Please make sure that your email address is correct and current. All payments and communications regarding future assignments will be sent to this address.

IMPORTANT: Your PayPal email address MUST match this email address.
PRIMARY ADDRESS
Address:*
Address2/Apt:
City:*
State/Province:*
Zip/Postal Code:*
Country*
 
SHIPPING ADDRESS (if above is P.O. Box)
Address:
Address2/Apt:
City:
State/Province:
Zip/Postal Code:
Country
 
CONTACT NUMBER
      Type: Number: Ext:
  *
SECONDARY ADDRESS
Add/edit/delete a secondary address?
Yes   No