INFORMATION  REQUEST 
FORM
   
Company:
 First Name/Surname: Address: Postal code:
Town/City: Provincie: Country:
Tel: Fax: E-mail (required):
Notes:

 I approve  

  I don't approve
To the processing of my personal data to be used only for purposes related to own business activities (pursuant to art. 10 law no. 675/96)

 
  

Brixia-Mec: Via Perotti, 35 - 25100 - Brescia - Italia - Tel/Fax +39 030 3583691
E-mail:info@brixia-mec.com