document.write("\n
\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Email
Name
Gender
Company
Phone
Adress
Postal Code
Place
Country
Model
Requested
Action:		Quotation
Demonstration
Documentation
My Question
I understand that by checking the box, my information will be shared with, and I may be contacted 
     by an Electrometric Representative. Your contact information will not be shared with third parties. \n
 
\n
\n
      Your rights:
\n
 
\n
\n
      I can withdraw consent to receive email notifications from us by emailing my contact information with
      the subject, \"Opt Out\" to info@electrometric.com. Further details on the use of personal data and the
\n
      withdrawal procedure can be found in our privacy policy.
\n
\n
\n
 
\n
 
\n
");