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Proposal Request Form
CONTACT PERSON FIRST NAME:
MI
:
LAST NAME:
CONTACT PERSON's CO. TITLE:
COMPANY NAME:
COMPANY ADDRESS:
COMPANY CITY:
COMPANY STATE:
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AL
AK
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AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IA
KS
KY
LA
ME
MD
MA
MI
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MS
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MT
NE
NV
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NJ
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NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
ZIP
:
AGENT'S CO. PHONE:
EXT
:
PRIMARY COMPANY PHONE:
COMPANY FAX:
COMPANY E-MAIL:
CONTACT PERSON E-MAIL:
HOW MANY LOCATIONS DO YOU PLAN TO HAVE SHOPPED
?
HOW FREQUENTLY DO YOU PLAN TO SHOP THOSE LOCATIONS
?
BRIEFLY DESCRIBE YOUR BUSINESS AND WHAT YOU WOULD LIKE TO ACHIEVE
...
WOULD A PURCHASE BE NECESSARY FROM THE SHOPPER
?
- If so, what is the average amount they would spend as a realistic customer?
HOW DID YOU FIND OUR WEBSITE
?
e.g. "Google - searched for Mystery Shopping Company".
ARE YOU READY NOW TO BEGIN A MYSTERY SHOPPING CAMPAIGN FOR YOUR BUSINESS?
Select One
Yes
Just Collecting Information
HAVE YOU USED MYSTERY SHOPPERS BEFORE?
Yes
No
DO YOU HAVE AN EXISTING MYSTERY SHOPPING FORM THAT CAN BE USED TO DEVELOP YOUR PROGRAM ?
Select One
No - We need a New Survey
Yes - We already have it
Yes - We have one, but need Something Better
PLEASE GIVE A BRIEF DESCRIPTION OF THE KIND OF STORES YOU HAVE:
WHAT ARE YOUR OBJECTIVES FOR MYSTERY SHOPPING?
WHAT IS YOUR COMPANY'S WEBSITE ADDRESS?
BEST TIME TO REACH YOU:
Select
9AM-12NOON
12PM-5PM
6PM-8PM
ANYTIME
WHAT INDUSTRY BEST DESCRIBES YOUR COMPANY:
Select
Automotive
Educational Facilities
Financial Institutions
Grocery Stores
Health and Fitness
Hotel and Resort
Insurance
Movie Theaters
Restaurant & Fast Food
Retail & Specialty
Transportation
ADDITIONAL INFORMATION / SPECIAL CONCERNS / COMMENTS:
By checking / signing this box I affirm that the above information is True and Accurate
.
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