REQUESTING THE PRODUCTS

ITA

Name*: Type name

E-mail address*: Type e-mail address

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Received form

Phone number: Type phone number

Address: Type e-mail address

City*: Type city

Zip Code: Type zip code

Country: Type country

I take on all legal responsibilities regarding the data inserted in the form

Surname*: Type surname

Marital Status*: Type marital status

Reason for requesting the products: Reason for requesting the products....

I accept that “Banco dell’Igiene” may decide irrevocably to refuse my request

SEND YOUR FORM VIA FAX

Download the PDF version to request your products.
Insert your data and print the form, then send your request via fax to 02 463522.