Name

Surname

Society name

City

Province

Zip Code

Address

E-Mail

Telephone

Fax

Request

I hereby authorise you to include my personal data in your list for the possible dispatch of illustrative, advertising or promotional material according to Law 675/96. At any time I will be entitled to ask for the amendment or cancellation of my personal data and to oppose their use by writing to the address indicated below. It is understood that such consent is conditional upon the observance of the law itself.

Pursuant to the privacy law, notice is hereby given that the supplied name will not be included in any file and shall only be treated for the necessary shipping procedures.