Order & Inquiry & Customer registration
※ Please fill in information on the inquiry and the customer registration.
First name・Last name
名前の姓
名前の名
Zip-code・Address
Zip-code・Address
E-Mail address
E-Mail address
E-Mail addressの確認用
*
E-Mail address. Input for confirmation.
Telephone
Telephoneの市外局番
-
Telephoneの市内局番
-
Telephoneの加入者番号
Date of birth
Date of birthの年
年
Date of birthの月
--
1
2
3
4
5
6
7
8
9
10
11
12
月
Date of birthの日
--
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
日
Question method
Question method
選択してください
Inquiry of Production
Production support
Member registration
Request of commodity
Request of original goods
Password issue
Paypal Payment
I .P.M .O Payment
Credit card Payment
Bank transfer Payment
① Content of inquiry ② Order products ③ Shop name ④ Occupation ⑤ URL ⑥ Others
① Content of inquiry ② Order products ③ Shop name ④ Occupation ⑤ URL ⑥ Others
※
English translation
*
Agreement of handling of individual information.
□
It agrees.
Please confirm here.
個人情報の取扱いへの同意
Protection of individual information
Please read of the following protection of individual information.
It comes as much as possible to protect individual information according to the policy below TAKENAKA Corporate Group official site (hereafter, this site).
★Article 1 I will observe the relating law and other standards for the handling of individual information.
★Article 2 When individual information is acquired, it does by an appropriate, fair means, and when the acquiring it, the purpose of use is notified and it makes it public for the customer himself.
★Article 3 The purpose of use will be specified as much as possible beforehand for the use of individual information, and I handle it only within the range necessary for achieving the purpose of use.
★Article 4 The information security measures are started to secure the accuracy of individual information and safety, the measure for safety is executed, and it tries to prevent the loss of unlawful computer access or individual information to individual information, destruction, the falsification, and the leakage, etc.
★Article 5 Protection of individual information is not managed only by easy mail dealings. Customer's individual information might be approved through the telephone and it confirm it responding to the necessity.
★Article 6 Individual information will be offered and I not offer it to the third party, except when there is a right reason. It concludes with a necessary contract consigning ahead, and moreover, when the processing of individual information is consigned outside, it manages proper and it supervises.
★Article 7 Our company will respond appropriately according to the law of individual information when indication, the correction, and the deletion to own individual information are requested by the customer himself.
同意する
お客様の端末に保存されている
前回中断された入力内容を復元しました
メッセージを閉じる
このフォームは「フォームメーラー」を使って作成されています
無料でフォームを作成する