Event Representative Application Form
Contact information
First name:
Last name:
SSN:
(Required upon hiring)
Address:
Address 2:
City:
State:
(Select)
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
ZIP:
Home phone number:
Cell phone number:
Email address:
Confirm email:
Education:
(Select)
High School
Some College
College Graduate
Masters
PHD
Technical Degree
Can you speak Spanish?
(Select)
No
Conversational
Basic
Fluent
Job reference number:
(if applicable)
When are you available to work?
Weekdays
Weekends
Mornings:
Afternoons:
Evenings
How far are you willing to travel?
miles
Minimum number of hours a week:
hours
Maximum number of hours a week:
hours
Field sampling experience
No interest
No experience
Some experience
Very experienced
Events
Hotels
Bars / Clubs
Retail Locations
Entertainment (Amustment Parks, Movie Theaters)
Health Clubs
Shopping Malls
Category experience
If you do not wish to work in a particular category, please make sure you select
Won't work
and you will not be contacted for work in that area.
Won't work
No experience
Some experience
Very experienced
Tobacco
Alcohol / Nightclub
Soft drinks
Hot drinks
Electronics
Notes / Text resume