WilmaNet by Ital GM

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>>> WilmaNet pre-registration form ...

1. PERSONAL DETAILS


Last Name :		First Name :
Sex :

2. DATE AND PLACE OF BIRTH

Date of birth :

Born in Italy :

NOTE: leave this field checked only if the new User was born in Italy, otherwise de-check it.

Born in (State) :

City or foreign country of birth :

NOTE: after typing correctly city or foreign country of birth, with TAB or ENTER the FISCAL CODE will be generated automatically.

Fiscal code :

3. RESIDENCY


Resident in Italy :	NOTE: leave this field checked only if the new User is resident in Italy, otherwise de-check it.
Address :
Street number :
State :		City :
Zip code :

4. INFORMATION


Telephone :		Fax :
Mail :		Mobile phone no :
User category :		Device type :

5. IDENTIFICATION

Type of ID :

Number :

Issued by :

Country :

Expiry date :

6. REGISTRATION DETAILS


The personal information here acquired will be treated by Ital GM S.r.l., main office in Anguillara Sabazia (RM), Via Anguillarese 50, Italy, V.A.T. reg. IT-05527311004 (the Holder/the Company) also by means of electronic and/or automated equipment, for possible communications related to goods and services of the Holder and for finalities directly connected to the service supplied (WilmaNet). The information required will be treated in full compliance with the Italian law that deals with privacy protection (IT D.lgs 196/2003). The present registration requires explicit consensus for personal data treatment/communication since otherwise the Holder will not be able to execute and process this registration phase, so, if consensus has to be denied, it is obligatory to cancel the registration process now close to completion by using the button at the bottom of the page which says CANCEL REGISTRATION. Once reached the end of the period in which Ital GM S.r.l. is responsible of the WilmaNet service, it has to hand over to the City Council of Trento the technical information associated to each user and strictly related to the use of the service in order to guarantee operational continuity.
I hereby give my explicit consensus in order to become a new user of the WilmaNet service:
The information could be used for communication and/or transmission of promotional material related to new services and products of Ital GM and/or of companies to which Ital GM is in commercial partnership and/or to verify customer satisfaction levels associated to the use of the WilmaNet service.To give your consensus, optional and always revocable by sending communication of this at the main office address mentioned above (by conventional post) or by sending an e-mail at the address privacy@wilmanet.it, for commercial and/or marketing purposes, or to express your dissent, use the option here available.
I hereby give consensus in order to receive promotional information :

7. VALIDATION




NOTE: please type here the code you see viewed inside the image in order to validate your details - letters are case sensitive.