Application for Registration

    Now, that you've made the decision to sign up with us please take a moment to fill out our short application and within 24 hours a representative will be calling you to confirm and process your application.

    Your Business Name
        
    Your Business Address
    Street:
    City:
    State/Terr:
    (IF USA)         		State/Province:
    (NOT USA)
    Zip/Postal Code: Country:
    Your Phone Number
    Area/Country Code: Phone Number:
    Your Web Address
        
    Your E-Mail Address
        

    Additional Business to Business Listing

    In addition to a listing in our Directory of Registered Safer Shopping Sites, you will automatically receive a free listing in our new Business to Business Directory The information here is applies to the business directory only.

    Please select a User Name     

    Please select a Password (REQUIRED - NO SPACES)

            ENTER      RE-ENTER

    Principal Business Activity     

    Key Words that would typically be used to find your business in a search engine or directory, List, 3 to 10 words separated by commas


    About you
    Your Age: Gender: Education:
    In what year did your company begin operations?
        
    How many people does your company employ?
        
    What is your return policy?
        
    What are your return terms?
        
    What is your policy on the use of customer the information you collect?

    Some user information may be shared with third parties.
    Some user information may be sold to third parties.
    User information is used for internal purposes only, is not shared or sold.
    Customer will not receive E-mail from the company after the transaction is complete.
    Customer is given option on use of information.
    Customer may receive E-mail from the company.
    Company does not retain customer information.
    We have not yet established a privacy policy.

    (Select the option below ONLY if your non-disclosure policy is PUBLISHED on your site.)

    Our Privacy Policy is published on the website.


    How do you handle customer service?
        
    Briefly describe your company.
        
    Do you have secure on-line payment processing (SSL/SET)?
    Estimated monthly sales and revenue
    Average monthly revenue?
    Transactions per month?
    Roughly how many visitors does your website get in the course of a month?
        
    What is the full name of the person in charge of customer service?
        
    Why are you applying?
        
    How did you find out about ePublicEye?
        


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    *By submitting this form I certify that the information in this application is true and accurate. Any misrepresentation, fraudulent statement, or material omission discovered will result in immediate loss of registration and a negative report filed on your company.

    If accepted, your company will be added to our directory and authorized to display the Registered Safer Shopping Site seal. The seal must be displayed prominently, linked to the ePublicEye site for 24 hour monitoring, and accompanied by instructions telling visitors to your site how to get and file reports on your business. By Submitting this application I accept these terms and authorize ePublicEye to publish consumer reports on my company.

    DOUBLECHECK YOUR INFORMATION ABOVE AND CLICK ...

    (IF THE SUBMIT BUTTON DOES NOT TAKE YOU TO THE NEXT SCREEN,
    RE-ENTER YOUR PASSWORDS MAKING SURE THAT THEY ARE IDENTICAL
    AND THAT THEY CONTAIN NO SPACES. IF YOU STILL HAVE PROBLEMS CONTACT US AT WMS@EPUBLICEYE.COM)