Testimonial Release Form - Di Moda European Lingerie

Testimonial Release Form

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Testimonial Release Form
for Di Moda European Lingerie

First name:

Last name:

Address:

City:

Prov.(State):

Country:

Please identify who you are:

Online customer

Store customer

Testimonial statement:

Through my submit below, I hereby authorize Dimican Inc to print my testimonial, in full or
in part, and to use in any marketing materials and on their website.

Note: Only First Name, First Initial of Last Name, City and Province (State) will be printed.

The information stated above is accurate and true to the best of my knowledge