TO ALL MATRIX OWNER

Window Cling/Poster Give Away Registration Form

(*) Compulsory fields
 
Salon Name (*)

  		Contact Name (*)
Street Address (*)

  		City (*)
 State (*)
 Zip (*)
Salon Phone # (*)

  		Contact Cell # (*)
 Email (*)
 Website (*)
Total Number
of Tanning Units (*)

  		Total Number
of Matrix Units (*)
  
Matrix Unit Serial #(s) (*)

  		Purchase Date(s) (*)
 Purchased From (*)
Security Code: Security Code New code
Insert security code:


By filling in and sending this module, I hereby authorise the processing of the personal data I provide, for the purpose indicated in point a) above, in the manner and within the limits indicated by the information contained herein, in compliance with and by effect of art. 23 of Legislative Decree 196/03.
I authorise:  Yes