| Please give your name and address:- |   |   | 
       
        | Title | Mr 
            
            Mrs 
            
            Ms 
            
            Miss 
            
            Dr 
            
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        | First Name(s) |  
            
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        | Surname |  
            
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        | Address |  
            
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        | Street Name |  
            
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        | City |  
            
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        | County |  
            
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        | Postcode |  
            
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        | Phone Number |  
            
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        | E-Mail |  
            
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        | What Contax equipment do you own? Please list all camera 
            bodies, lenses, flashes and major accessories, together with the serial 
            number where there is one. | 
       
        | Item (Please tick) | Serial Number (s) |   | Date (s) of purchase | 
       
        |  
            
              Tix |  
            
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        |  
            
              TVS III |  
            
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        | TVS Digital |  |  | 
       
        |  
            
              G1 |  
            
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              G2 |  
            
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              Aria |  
            
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        |  
            
              RX |  
            
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        |  
            
              RTS III |  
            
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        |  
            
              AX |  
            
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              645 |  
            
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        |  
            
              N1 |  
            
           |  
            
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        | N Digital |  |  | 
       
        |  |  | 
       
        | Lenses |  
            
           | 
       
        | Accessories |  
            
           | 
       
        |   |   |   |   | 
       
        | Is there any other Contax equipment you would 
            like us to register? | 
       
        | Item | Serial Number (s) | Date (s) of purchase | 
       
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        |   |   |   |   | 
       
        | What items of Contax Equipment do you 
            hope to buy in the next 1-2 years? (In case of lenses, please 
            indicate the focal length) | 
       
        |  
            
             Flash |   |   |   | 
       
        |  
            
             Lens (Focal Length) |  
            
           |   | 
       
        |  
            
             Another body  |   |   |   | 
       
        |   |   |   |   | 
       
        | Are you an amateur or professional 
            photographer? | 
       
        |  
            
              Amateur    
            
            Professional | 
       
        |   | 
       
        | For what subjects would you normally use your 
            Contax equipment ?  Please tick all that apply | 
       
        |  
            
              Family |  
            
              Holidays |  
            
              Landscape |  
            
              Studio | 
       
        |  
            
              Scientific |  
            
              Creative |  
            
              Glamour |  
            
              Nature | 
       
        |  
            
              Sports |  
            
              Other hobby  |  
            
              Reportage |  
            
              Close-up | 
       
        |   |   |   |   | 
       
        | Which is your favourite photo magazine? | 
       
        |  
            
              Amateur Photographer |  
            
              Practical Photography | 
       
        |  
            
              British Journal of Photography |  
            
              Which Camera? | 
       
        |  
            
              Outdoor Photography |  
            
              Buying Cameras | 
       
        |  
            
              Professional Photographer |  
            
              Other (please specify)  | 
       
        |   |   |  
            
           | 
       
        | Please let us know through which Contax Specialist Dealer 
          you most often purchase Contax Cameras and Accessories | 
       
        | Dealer Name and Location 
 | 
       
        | If you feel it appropriate it would also help us if you 
          could comment on the general level of service and support that you get 
          from this dealer or perhaps let us know why you use this dealer in particular- 
          please use the box below. | 
       
        |  | 
       
        | Kyocera Yashica, the UK importers of Contax Equipment, 
            may permit other reputable companies to make offers of products or 
            services which we believe to be of interest. If you would like to 
            receive this information, please tick this box.  
            
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