Evaluator Appication Form

*Last Name

*First Name

*Address

*City

*State

*Zip Code

*Main Phone #

Alternate Phone

Fax

*Primary E-mail Address

*Date of Birth (MM/DD/YYYY)

*Gender

Marital Status

Occupation

Industry

Evaluator Experience

If Yes, how many years?

To avoid a conflict of interest, please be sure to list ALL restaurants you have been employed by.

*When are you available to do evaluations?

Frequency (a month)

*Where are you willing to do evaluations?

How did you hear about EyeSpy?

*Why would you like to become an EyeSpy Evaluator?

Please read the Evaluator Contract Agreement and check the box to accept.

Image Verification

*Enter the code you see in the image above (case sensitive)