Viale dell’Industria,9 37135 Verona – Italy
Tel +39 045 8289111
Fax +39 045 8289122
Company Name*:
Name*:
Surname*:
Address*:
City*:
Province*:
Country/Nation*:
Email*:
Phone:
How did you know Polin? InternetCollegueMagazineOther
Note:
the undersigned:
1. has previously carefully read and understood in all its parts the above information; 2. he is perfectly aware of his rights; 3. acts in total freedom and without any conditioning and / or psychological pressure; all this stated
to the collection and processing of personal data, necessary for the purposes referred to in point a) of the aforementioned information.
The undersigned also expresses his own specific and explicit consent, for the purposes referred to in point b) of the information sheet and therefore consents to the receipt of advertising material / communications, such as, for example, brochures, invitations, newsletters, by post, email, telephone, fax, sms, mms and similar tools, deriving from the Owner. It is understood from now on that it is a specific right of the undersigned to revoke this consent at any time by contacting the Data Controller.
Product:
Year of construction*:
Registration number**:
** We are sorry, we are unable to consider your request in the absence of the serial number
