*Name:   *Surname:
Company:   *Mail:

Granted that

the undersigned: 1. has received before now, carefully read and understood all the parts of the informative specified at art. 13 Law Decree 196/2003; 2. has perfectly understood his/her rights by means of art. 7 Law Decree 196/2003; 3. is acting in absolute freedom and without any psychological conditioning and pressure; all this said

he/she expresses the broadest consent

to collect and process his/her shared personal and, if the case, sensitive data, necessary for the purposes of which at point a).

(Signature replaced by the tick)
Consent for "direct marketing" (optional)
The undersigned expresses its specific and explicit consent also for the purposes of which at point b) of the informative and therefore allows to receive advertising material/communications through post, email, telephone, fax, sms, mms and similar from the Holder. It remains from now on that the undersigned is entitled to the precise right of revoking this consent at any time by applying to the person in charge of verifying with those involved.

(Signature replaced by the tick)