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The information provided in this form will help us to serve you better. We will treat this information as confidential. As a member of pixetra club, you will be entitled to receive all communications, services, privileges and facilities applicable to pixetra club and all pixetra stores in India.
  * Mandatory Fields
Membership Type :*
Membership Amount :*
Rs. 1500
Full name :*
Your name as you would like it to appear on your membership card :*
Address :*
(All communication from pixetra will be sent to this address)
City :*
State :
Pin Code :
Telephone Number1 :*
Telephone Number2 :
(please include STD code)
E-mail :*
Confirm E-mail :*
Date of birth :*
Sex :*  Male  Female
Occupation :*
Education :
Do you own a camera/ video camera/ binocular/ telescope or any other optical imaging product?*  Yes  No 
If yes, Brand/ Model
Have you done any formal photography training?*  Yes  No
Tell us about your photography :
Your area of interest in photography :
What kind of activities would you like to see of pixtera club?
Would you like to be updated on promotions, club activities and products?  Yes  No
How did you hear about pixetra?*
 
Please enter code*

Declaration:*
 I wish to join pixetra club. I have read the terms and conditions of the club and agree to abide by them.

 
 
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