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\n\n\n\n
Email*
Name*
Gender* Mr.  /    Ms.
Company
Address
Postal Code
Place
Country*
Phone
Brand
Model
Requested
action		 Send me a Quotation
Contact me to shedule a Demonstration
Send me 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

\n
Your rights:
\n
 
\n
\n
I can withdraw consent to receive email notifications from Electrometric by emailing my contact information with the subject, \"Opt Out\" to info@electrometric.com. Further details on the use of personal data and the withdrawal procedure can be found in our privacy policy.
\n
 
\n
\n
\n 
 
\n
");