INFORMATION FORM

Company name:
Full address:
Phone:
Fax:
E-mail:
Person in charge:
Position:

Departments of interest:
Solids Liquids
Semi-solids Injectables
Water treatment Packaging materials
Additional details
(if possible, please indicate type of machine, capacity, product, etc):
I authorize this Company to use my personal information (Italian Law 675/96).