CUSTOMER CONSENT FORM

USE OF PERSONAL DATA FOR MARKETING PURPOSES

I herewith agree that details about my person (name, address, telephone number, fax number, e-mail address, and profession or comparable data) and my operation (my machinery, size of business or comparable data) may be collected and electronically stored by Henton and Chattell.
The stored data are used for the purposes of customer service and advice, for market and opinion research, to establish customer satisfaction and to send out information and marketing material.
I agree that for the purposes mentioned above Henton and Chattell may contact me in the following manner (please check all applicable boxes):

FOR HENTON & CHATTELL USE ONLY