Subscription Request

Edition:

Print Edition

Digital Edition

Subscriber Information:

Fields with are required.*

First Name*	* RequiredMaximum 20 characters allowed.
Last Name*	* RequiredMaximum 20 characters allowed.
Job Title*	* RequiredMaximum 38 characters allowed.
Company*	* RequiredMaximum 38 characters allowed.
Address 1*	* RequiredMaximum 38 characters allowed.
Address 2	Maximum 38 characters allowed.
City*	* RequiredMaximum 23 characters allowed.
State*	* Required
Zip Code*	*Valid Formats Invalid CodeMaximum 10 characters allowed.
Country*	* Required
Phone*	* Required Invalid Phone NumberMaximum 20 characters allowed.
Email*	* Required Invalid Email AddressMaximum 50 characters allowed.
Re-Type Email*	* Required Email does not match

Your email address will be used to send digital editions, renewal notices, optical industry news, and information about optical products and services.

I AGREE
Here at Vision Monday we take your privacy seriously and will only use your personal information to administer your subscription account and to provide the products and services you have requested from us. Your data will be securely managed in accordance with the EU General Data Protection Regulation and our Privacy Policy.

Check Your Subscription Term:

	United States	Canada/Mexico	International
1 Year	$90.00	$243.00	$359.00
2 Years	$163.00	$388.00	$630.00
3 Years	$229.00	$581.00	$978.00

All prices are in U.S. dollars and include shipping and handling.

Please check the ONE category that best describes your job title:

If Other, please specify

Which best describes your business?

If Other, please specify

What is the approximate sales volume at your business?

Is this a single location practice/dispensary, or is it part of a multi-location group of practices/dispensaries?

If part of a multiple location group, how many practices/dispensaries in the total group?

Enter Your Credit Card Information:

Card Number	Invalid Card
Expiration DateYear	Invalid Date
CVV Code	What is this? Required (Numeric)

Consent to Share:

I agree to receive emails and other communications from the publisher and its affiliates about their products and services. I understand that I may withdraw my consent at any time. Please refer to our Privacy Policy or contact us for more details.