Consolidated Shipment Service - Estimate Request Form

Please fill in the form below and click on "continue" button below.
Fields marked by * are mandatory.

Contact data

Full name:	*
acting as (Title):	*
of the company:	*
having its registered office in (City):	*
address:	*
e-mail address:	*
web site:
telephone number:	*

requests the receipt of an estimate for the purchase of the following wines:
(fill at least for 1 wine):

Wine 1

Wine Name:	*
Area of production:	*
Price range:	*
Specific labels:
Other:

Wine 2

Wine Name:
Area of production:
Price range:
Specific labels:
Other:

Wine 3

Wine Name:
Area of production:
Price range:
Specific labels:
Other:

Wine 4

Wine Name:
Area of production:
Price range:
Specific labels:
Other:

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Enoteca Italiana guarantees the privacy and security of its users according to italian D.Lgs 196/03. In order to provide you our services, we may collect information you gave us sending a form in our web site. According to Italian Law (art. 7 - D.Lgs 196/03) you may ask us (writing an email to info@enoteca-italiana.it) what personally identifiable information of yours is collected, how and when we might use it and who has access to it. At any time you may also ask us to correct any inaccuracies in your information or you may ask us to delete it from our archive, by writing to: Responsabile del trattamento dati personali c/o Enoteca Italiana - Via Camollia 72, 53100 Siena ITALIA.

Do you accept the privacy statement?   Si  No  *

Export Department

Alessandro Mugnaioli and Cesare Montomoli

Ph.:	+39 0577 228828 / 228825
E-mail:	pmo@enoteca-italiana.it montomoli@enoteca-italiana.it
Fax:	+39 0577 228888

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