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Request for material

Inquiry form

About the input is careful

(1) ※The seal is a required item. Please input by all means.
(2) Please input all the katakana with full size.
(3) Please input a phone number (a company or cell-phone) to get of the communication into a phone number column by all means.
(4) If input is over, please click "the contents confirmation" under the form.
(5) As contents confirmation screen opens, after confirming input contents, I click "the transmission" and am completion.

On inquiring it

■You read "a privacy policy" on an inquiry, and please refer after an agreement.
■An answer may take time. Please refer for the dispatch over a telephone.
Circle glorification mechanic TEL: 093-451-0538
Your company's name ※required
Example) 0 0
Furigana ※required
(Katakana)
Example) 0 0 kabushikigaisha
Person in charge ※required
Example) Taro Yamada
Furigana ※required
(Katakana)
Example) Yamada Taro
Zip code
Example) 012-3456
The metropolis and districts
Municipality
Address, name
Phone number ※required
E-mail address ※required

Only as for note) half size alphanumeric character
Return address you like ※required
Request material
Inquiry contents ※required
Circle glorification mechanic
〒803-0186
Kokuraminami-ku, Kitakyushu-shi, Fukuoka 910, Shindoji
TEL 093-451-0538
FAX 093-451-0583
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