Puma Student Deal Application

Student Information

Cell Number

First Name

Last Name

ID Number

Student Number

Eye Care History

Do you currently wear glasses / contact lenses?

When last did you have an eye test?

How did you hear about us?

Please attach a photo of your ID or driver's license

Please attach a photo of your Student ID

Terms & Conditions

I confirm that the above information is correct. I consent that my personal information may be used purposes of this offer, which may include sharing my information with suppliers and medical aids where required. I also consent that VB Optical may contact me using the above information by SMS, Whatsapp, Email or any other available way. I confirm that I have read and understood the above and accept the terms thereof, and agree to the terms and conditions as per VB Opticals website on www.vboptical.co.za.

I agree to the above terms and conditions