Become a PulseBack Evaluator

Become a PulseBack Evaluator

PulseBack prides itself in having a superior field force. Our field evaluators are held to a stringent level of professionalism and are rewarded for their performance. Working as a PulseBack field evaluator is a great way to earn extra spending money in your spare time. Hours are generally flexible and won't infringe upon your normal job. Payment varies depending on the job and the time need to complete it. If you believe you possess the qualities necessary to join PulseBack's field force, please read the language below and submit our application form.

The purpose of this questionnaire is to obtain information that will allow PulseBack, Inc. to retain the services of qualified independent contractors to participate in its field evaluator program. This questionnaire is not an application for employment with PulseBack, Inc. To be considered for mystery shops or field evaluator assignments, please fill out this questionnaire accurately, completely , and legibly. Failure to do so will result in immediate disqualification. Any falsification or omission of information may also result in disqualification for PulseBack's field evaluator program.

Evaluator Contact Information

First Name:
Last Name:
Address 1:
Address 2:
City:
State:
Zip:
Home Phone:
Work Phone:
Fax:
Email:

Male:

Female:

Education

High School:		College Degree:
Some College:		Post Graduate:

Where did you get our name?

PulseBack Website:		Guest Perceptions:
Mystery Shoppers Online:		Volition:
People Resources:		PulseBack Email:

Other:

Experience

By submitting this form, I acknowledge that I have read and agree to the following statements:

I understand that by submitting this questionnaire, I am expressing my interest in participating in PulseBack, Inc.'s field evaluator program by providing services as an independent contractor, and not as an employee or agent of PulseBack, Inc. If my services are retained, I will be solely responsible for reporting all income received from PulseBack, Inc., and for paying all pertinent federal, state, and local taxes, and any other taxes and assessments levied by governmental authorities, as well as all other pertinent liabilities or payments. I understand that during my participation in the field evaluator program, I will remain free to perform services for any other person or business, so long as I continue to provide the services I have agreed to provide to the program. I also agree not to disclose or share any PulseBack materials to any parties or companies without PulseBack's written consent. I understand that my participation in the field evaluator program is not guaranteed, that PulseBack, Inc. may discontinue my services at any time and for any reason without advance notice, and that I have a similar right. I certify that all information given on this questionnaire is complete, accurate, and true, and that any falsification of information on this questionnaire and/or failure to supply requested information will result in disqualification from the program.