company | contacts | registration |

REGISTRATION

For being able to carry out the purchases of the site www.intimouse.com it's necessary to be registered.
Insert the data in the below fields.
You will receive an email with the data in order to confirm your registration.
Please be informed that incorrect or missing fields will NOT allow the registration of data.
Remember that only alphanumerical and some special characters are allowed in module (1...9,a...z,+-/() )

Name and Surname

Company

Address

City

ZIP code

State

E-mail

Confirm e-mail

Telephone

Fax

Mobile Phone

Skype ID

Live Messenger ID

Please tell us more about your company:

open market
shop
wholesaler
agent
chain shops
department store
import/export
manufacturer
other

Information about Legislative Decree no. 196 of 30 June 2003
The data submitted through this form shall be processed manually and with the use of electronic means with the purpose of meeting your enquiry.
In no way will the data be divulged to third parties. The submission of data is not compulsory; refusal shall not entail any consequences.
In accordance with Legislative Decree no. 196 of 30 June 2003, you shall have the right to access your data, request its deletion , updating, rectification, integration and to object its processing by contacting the Intimouse di A. Contarin, or by writing at the following e-mail address: taac@intimouse.com.
The submission of data through this form represents the authorization for the processing of the same.

I authorize the processing of my personal data
I do not authorize the processing of my personal data