order form

    Customer Information

    Is required.

    Name

    Furigana

    Your company name


    If you are an individual, please write "individual"

    Your company name

    Industry

    Post Code

    Address

    Phone

    FAX

    E-mail address

    Delivery(It will be delivered by courier.)

    delivery date

    After payment is confirmed, it will be shipped in the shortest possible time.

    * Please enter your desired delivery date in the remarks column.

    Delivery time

    Delivery time is morning arrival.

    (Not guaranteed.)

    *Delivery time may be delayed due to traffic conditions.

    * Please fill in the remarks column for the desired time other than morning arrival.

    Shipping address

    *If you have selected a different delivery address, please enter the delivery address.

    Post Code

    Address

    Products

    *If ordering as a set, please enter the quantity for both.

    Chrome-plated wagon (body)

    Quantity:

    Chrome-plated wagon (upper basket)

    Quantity:

    Chrome Plated Wagon (Body/Upper Basket Set)

    Quantity:

    Panel output sheet
    Size: A1

    Quantity:

    Panel output sheet
    Size: A2

    Quantity:

    Panel output sheet
    Size: A3

    Quantity:

    Payment method

    Select payment method

    Other

    Remarks column

    This is a customer-specific form.
    Please refrain from contacting us for the purpose of sales, as we cannot respond to inquiries.

    If you do not receive an e-mail from our company or an automatic reply e-mail, it may have been automatically sorted into the spam folder or trash box, so please check it once.

    No confirmation screen will be displayed.
    Please check the box if the above information is correct.