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01. Full name of user
02. Street and number of estate
03. Zip code
04. Locality
05. Country
06. Telephone 1
07. Telephone 2
08. Fax
09. E-mail
10. www
11. Legal form
12. Year of foundation
13. Management 1
14. Position 1
15. Management 2
16. Position 2
17. Person designated to contact
18. E-mail of person designated to contact
19. I agree on receiving information about offers
from Trade Ent. "ARTPOL" by electronic road
20. I’m interested in the contact with sales
representative of Trade Ent. "ARTPOL"
21. Language
 
* required fields
Remarks:
I agree on processing my data, that are included in this registration form, by Trade Enterprise "ARTPOL" – Artur Poplawski seated in Radom, 177/179 Warszawska Street
as well as by subjects to whom Trade Enterprise "ARTPOL" – Artur Poplawski charges essential actions to come into contact and over which holds the full control
in the range essential to assure protection of personal data.
I was informed about an access to my data, their improving as well as withdrawal of agreement on their processing in marketing purpose, which entitles me.
According to law about providing services by electronic road, of 18th July 2002, I express my agreement to Trade Enterprise "ARTPOL" – Artur Poplawski to contact
me by electronic road.
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All required fields should be filled correctly.