Online Submission Page

To participate, please fill up the form below with your details.

* Required

Full Name of Participant *

Name of Participating Outlet *

Receipt number (“Proof of Purchase”) *

Receipt Upload OR Authenticity Card Upload *

Screenshot of Advertisement Image *

Brand / Product Purchased *

Essilor® Stellest® 1.0 Lenses

Essilor® Stellest® 2.0 Lenses

I confirm that the information submitted is true and accurate. In the event the information submitted is found to be fraudulent, erroneous and/or incomplete in any way, I acknowledge that my participation in the Promotion may be rejected or deemed void at the Company’s sole discretion. *

I acknowledge that I have read and understood the Terms & Conditions and Privacy & Policy, and consent to the collection, use and disclosure of my personal data by EssilorLuxottica Asia Pacific Pte Ltd. for the purposes set out therein. *

Further to the Privacy & Policy, and notwithstanding any existing registration with the DNC Registry, I would like to receive information about the goods and services which may be provided by EssilorLuxottica Asia Pacific Pte Ltd. and their partner outlets, including (but not limited to) offers, promotions, sales and marketing communications, and information about new goods and services, via newsletters, emails and/or text messages.