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Name and surname
name
surname
Indietro
Avanti
Date of birth
-
Mese
-
Giorno
Anno
Data
Indietro
Avanti
COUNTRY
Indietro
Avanti
Email
esempio@esempio.com
Indietro
Avanti
Do you have children?
Seleziona
no
yes
Indietro
Avanti
What is your job?
Indietro
Avanti
Do you have a pc?
Indietro
Avanti
Do you have a phone?
Indietro
Avanti
How do you rate your level of digitalization? ( 0= I have no digital expertise; 5 = I am very digitalized)
1
2
3
4
5
Indietro
Avanti
Gender
Seleziona
male
female
other
Invia
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