Registration Form: Guest Book

Registration Form

[Guest Book]

(Italian Form: click here)

Obligatory data

(Visible data)

First Name:		Last Name:
E-mail:		City, State/Province, Country:

Optional data

(Visible data)

Are you a Gold Prospector?	NO	YES
		If you have selected YES, what type of accessories do you use?

Comments into the Guest Book (personal and/or on the web site):

Invisible data

(The answers to this section won't be public)

Date of birth:		Sex:	M F
Mail address:		ZIP:
Telephone:		Fax:
Occupation:		Hobbies:
If you have a personal Home Page on Internet, indicate the address:		Notes about Home Page:
How do you have known this site?		If you have chosen "#" then specific which, if "Elsewhere" specific how:
Are you associated with any organizations of Gold Prospecting?	YES NO	If you have selected "YES" then indicate which:
Do you read magazines of Gold Prospecting regularly?	YES NO	If you have selected "YES" then indicate which:
Would you like to receive possible catalogs and/or informations from Manufacturers/Retailers of Gold Prospecting?	YES NO	If you have selected "YES" then specific how (both also):	Mail E-mail

To send your data press the button and wait the response

If you don't receive the response please send an e.mail to:

metaldetecting@worldonline.it

Your data will be displayed in the next days!

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