Complimentary Office Poster & Dispensing Mat Offer
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Where did you first hear about this offer?
Vision Expo West
KODAK Lens Representative
E-blast
Trade Publication
Other  
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Please select the number of 24x36 (portrait) posters you would like. Limit one per practice location. Quantities are limited.

1
0
N/A
Required

Please select the number of 19x12 dispensing mats would you like. Limit one per practice location. Quantities are limited.

1
0
N/A
Required
Please enter the information indicated below to receive your complimentary KODAK Lens poster and/or dispensing mat. Please note that this offer is only available to practices within the U.S. and we cannot deliver to a PO Box. Please allow up to 4-6 weeks for delivery.

First Name:
Last Name:
Company Name:
Work Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

To receive periodic updates regarding KODAK Lens products and promotions, please provide your email address here. There is always an option to unsubscribe.

 

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What message do you feel the "See the Colors of Life" KODAK Lens ad campaign is trying to convey?
 

350 characters left.
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Do you currently dispense KODAK Progressive Lenses?

Yes
No
I don't know
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Do you participate in PracticePlus (Signet Armorlite's product support program for KODAK Lenses)?

Yes
No
I don't know
I want more information about KODAK Lenses. Please contact me by:
Phone (add phone number in comments box)
Email (add email in comments box)
Mail (add address in comments box)
No need to contact
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