FORM MAIL

Please complete in full the information request form.

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Name * Surname *

City * C.A.P. - Italy only

Region/Country Estero AG AL AN AO AP AQ AR AT AV BA BG BI BL BN BO BR BS BZ CA CB CE CH CL CN CO CR CS CT CZ EN FE FG FI FO FR GE GO GR IM IS KR LC LE LI LO LT LU MC ME MI MN MO MS MT NA NO NU OR PA PC PD PE PG PI PN PO PR PS PT PV PZ RA RC RE RG RI RM RN RO RR SA SI SO SP SR SS SV TA TE TN TO TP TR TS TV UD VA VB VC VE VI VR VT VV  * State

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(*) Compulsory fields.

According to Italian Law n.675/96 on "personal data protection", I declare to have understood
the following: my personal data requested will be used for statistical and research purposes
and to communicate the result of possible requests.  I shall ensure to send you corrections, 
variations and/or integrations of data in your possession and I declare to be acquainted with 
the complete text of the art.13 of the Law n. 675/96 relating to the rights of the party concerned

I declare to have read the information and I express my consent

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