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Canon HD Prosumer Promotion

To claim for your Cash Back, fill in this form and press the Register and Print button at the bottom of this page.

* Indicates required information.

I consent to Canon processing my personal data provided in this entry form for the purpose of administering the cashback promotion. *

Title

First Name *

Last Name *

Email Address *

Confirm Email Address *

(this is for validation purposes only)

Address 1 *

Address 2

City *

Post Code *

Country *

Language *

Telephone Number *

Mobile Number

Date of Birth *


Day	Month	Year

Products *

Which store did you purchase the Canon Products from? *

Which city did you purchase your Canon Products in? *

When did you purchase the Canon Products? *


Day	Month	Year

Where did you hear about this Canon promotion? *


	I accept the site's Terms and Conditions *
	If you are under 18 your parent or guardian must accept your registration by ticking this box

Mailing Preferences

Tick the box if you would like to:
	- receive Canon's monthly e-news letter and information about new Canon products and services
	- be invited to participate in marketing research activities from Canon

Email and newsletter options.
In which format would you like Canon emails to be sent?
	Receive emails in plain text format Receive emails in HTML format

Canon Cash Back Checklist:
Please check that you have the following items when mailing your cash back claim:
	The original entry form correctly filled out.*

	A photocopy of the proof-of-purchase or copy of cash register receipt for your Canon products. *
	All original barcode of the product boxes listed in the application form. *