CONNECT Application Form

1
Name* This field is required.
Mr.
Mr.
Mrs
Miss
Ms.
Title
First Name
Last Name
2
Phone Number* This field is required.
Please enter a valid phone number.
3
Email* This field is required.
example@example.com
4
Store Name and Location* This field is required.
5
1. What OM SYSTEM / Olympus product (if any) do you own and shoot with?* This field is required.
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Ok
6
2. How long have you worked in the photographic industry, and for what kind of organisations?* i.e., retailers, wholesalers, photographers, brands etc.* This field is required.
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Ok
7
3. What is it that makes the OM SYSTEM product stand out for you?* This field is required.
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Ok
8
4. Why should OM SYSTEM choose you to be in this program?* This field is required.
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Ok
Should be Empty: