Register your M.ROBERT helmet by filling in your data in the form underneath.:
Purchaser
First Name *
Family Name *
Address *
Town *
ZIP Code
Country *
E-Mail *
Helmets
Model Reference *
Colour *
Size *
Homologation Number *

( (Ex. E3051234567P to be typed with no spaces or dashes)

The number is on the ticket sewn to your chin-strap
Information on the purchase
Date of purchase (dd/mm/yyyy) *
Store/Dealer *
Invoice Number / Ticket Receipt Number *
Amount paid for the helmet *
Where did you buy the helmet
Name of the Dealer
Address
Town
Zip Code
Country
1. Why did you choose a M-ROBERT helmet ? *
Graphics and design Brand
Quality Safety
Comfort Competitive Price
Advertisement and magazines Have you owned a M-Robert helmet before?
Recommended by the dealer Recommended by a friend
Other
2. What helmet did you use before purchasing a M-ROBERT helmet ? *rima di acquistarlo? *
Altro
3. What type of motorcycle do you ride? *iedi? *
4. What motorcycle magasines do you regularly read ? *
Motocross Motosprint
In sella In moto
Moto Hi Power Gq
Maxim Men’s Health
Max Al volante
Auto Auto Oggi
Biker’s Life Capital
Class Due Ruote
National Geographic Panorama
L’espresso Quattroruote
Other
5. How old are you? *
6. Sex * M F
7. What are you currently doing? *
Other
8. For how many years have you used your helmet before buying a new M-Robert helmet ? *
Years +
Months
9. Help us improve our product with your suggestions! *
Conforming to the Italian Law n. 196 of june 30th 2003, I hereby explicity authorise the use of my personal data.

(Civil Code for the Protection of Personal Privacy)
I authorize I do not authorize
The fields with (*) must be filled in.