Subject (title) |
Inquiries regarding registration
|
Required country |
(Please select a country)
|
Required applicant name |
[First name/Sur name]
|
Required applicant Kana |
[First name/Sur name]
|
Required existing direct transaction |
|
Required corporate name (organization name) |
(全角で入力してください)
|
Required representative name |
[姓] [名]
(全角で入力してください)
|
Required representative (Kana) |
[姓] [名]
(全角カタカナで入力してください)
|
Required postal code |
(Enter in 7-digit numbers)
|
Required prefectures |
(Please select the prefecture name)
|
Required address (county, city, ward) |
(Enter county, city, ward)
|
Required address (town name) |
(Enter the town name and street address)
|
Address (building name, etc.) |
(Please fill in the name of the condominium / building, etc.)
|
Required contact phone number |
(Enter in hyphen (-) delimiters including country code. Example: 010-3-0000-0000)
|
必須業種 |
(Please select an industry)
|
remarks |
|
Required Email address |
(Enter an address that includes @)
|
Required email address (confirmation) |
|