Your name (required field)
Your phone number (required field)
Your E-Mail-address (required field)
Declaration of consent:
Yes, I / we agree that my/our contact details
(name, address, fax number and E-mail address)
to process your request stored and used to contact.
It is clear to me / us that these consents are voluntary
and are revocable at any time. The revocation is by e-mail
to be addressed to: email@example.com or by post
to: Haus Nussbaum, Gudrun W.-Kriegshäuser, Pirolweg 1,
Upon receipt of the cancellation, we will be the concerned
data not use or process and delete data.
Spam security - please answer the question:
Six plus 3 = ?
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