Shopper Panel - Registration | Suburbia Advertising | Canada's leading retail branding agency

Shopper Panel - Registration

We are looking for enthusiastic shoppers who have opinions about shopping. Whether you are simply a window shopper or a ‘shopaholic’, we want to hear from you. Just complete the sign-up form and let us know more about your shopping habits.

If you are interested in becoming a Suburbia Shopper Panel member, please complete this form.

Shopper Panel - Registration First Name: *

Last Name: *

Email Address: *

City: *

Province/State: *

Country: *

Gender: *
Male
Female

Age group: *

Please indicate your household income range: *

How many children are in your household?: *

How did you hear about the Suburbia Shopper Panel?: *

Please enter name of person who referred you

Tell us about your shopping habits How often do you buy products and services online?:

Do you subscribe to any Shopping or Retail related e-newsletters?:
Yes
No

If yes, please list the e-newsletters you subscribe to: