INTEGRAF--Holography Forum Benefits Program

Welcome to the Sign Up and Agreement Form for the

Holography Forum Sponsorship Program

How to Use This Form

All blanks and fields must be completed to submit this form successfully. Use the <TAB> key or your mouse to jump to the next field. When you've completed the form, simply click on < Submit Registration> a the bottom of the page.

Integraf respects your privacy and will absolutely not share your personal information from this registration with third parties other than the administrator of the Holography Forum. Sharing some information with the administrator of the Holography Forum may be required to coordinate this sponsorship program and to provide you valuable benefits.

Step 1 Personal Contact Information
	Last name
	First name

	Email Address
	Confirm email address (by retyping it)

	Phone number

Step 2 Holography and You

	Holography Forum Membership
	What is your username in the Holography Forum ?
	When did you first join the Holography Forum?

	Tell us a little bit more about yourself
	Your Primary Occupation and Title
	Organization name (or type "none")
	City, State/Region & Postal Code
	Country
	How long have you been making holograms?
	Which statement best describes your involvement in holography?

Step 3 Connecting with You
	To provide you with the best products, services, and prices, we'd like to keep in touch with you.
	Yes, I'd like to know about other Holography Forum discounts, benefits, and news from Integraf via email periodically.
	Yes, I'd be glad to provide my suggestions and feedback on Integraf's products and services.
	Integraf respects your privacy and will email you only periodically when there is pertinent information to share. At any time, you can cancel subscription to our email by contacting us.

Step 4 Benefits Agreement

	I understand the purpose of this Sponsorship Program is to help artists, hobbyists, and individuals who are active Holography Forum members. As such, I hereby agree that purchases I make from Integraf that take advantage of the benefits offered through this sponsorship program are and will be for my personal use or for my holographic art studio (amateur or professional), and not on behalf of any other institution or business operation. Integraf reserves the right to withhold, modify, or cancel benefits to any party for any reason.

Step 5 Submit Registration

Type the security code below into the box and then click Submit Registration.

After clicking on the "submit registration" button below, you will be led to a page that confirms that your form has been submitted. You will receive an email confirmation within five business days.

Thank you!