Silhouette Vision Checker Form

Ms * Mr *

First Name *

Last Name *

Email *

Birth Year **	Birth Month **	Birth Day **

You must be at least 18 years old to take this test. Our system has detected that you are under the required age. We recommend waiting until you meet the age requirement before proceeding. Thank you for your understanding!

Country *

Language *

Yes, I would like to subscribe to the Silhouette newsletter and be informed about trends, promotions and vouchers by e-mail, post or messenger service, as well as receive personalized product and service offers from Silhouette. You can unsubscribe at any time. Information on the use and protection of my data can be found here.

** Date of birth is mandatory as this test is a medical device to determine your sight and you have to be 18 and older to complete it

Thank you! There's just one more thing to do.

You will shortly receive an email from us in which you can confirm your registration and will then be forwarded to the Vision Checker.