Nuova pagina 4

	IF YOU WISH TO PROMOTE YOUR PRODUCTS, YOU MAY FILL IN THE FORM BELOW WITH YOUR DETAILS:
	*Company Name ()**
	Operating sector
	Address: Street
	N°
	Postcode
	Place
	*Town ()**
	*County ()**
	*Country ()**
	*Telephone ()**
	Fax
	*E-mail ()**
	WEB Site
	Indicate the product you wish to promote:
	Additional Notes
	DETAILS OF THE PERSON WHO FILL THE FORM:
	Name and Surname
	Position in company
	Date form is filled in

N.B. The fields marked with the asterisk (*) are compulsory.

I hereby authorise use of my personal data under the Italian law in Privacy
(Legge 675/96 del 31/12/1996)