order form

    Customer Information

    Is required.

    Name

    Furigana

    Your company name


    If you are an individual, please write "individual"

    Your company name

    Industry

    Zip 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.

    Zip 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:

    Payment method

    Select payment method

    Others

    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 is displayed.Please check if the above contents are correct.