Fill out the form below and click on the "Next" button.
Order Details
Order reference no.:
(Enter only if needed)
Product code
Quantity (pieces)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Product code
Quantity (pieces)
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
Comments:
Type of business:
Manufacturer
Trading company
Public office
Educational institution
Individual
Other
Order history:
Have placed an order before
First time
Name of company:
(required)
If not a company,enter"Not".
Department:
Name:
(required)
E-Mail:
(required)
(Example)order@hirosugi.co.jp
TEL:
(required)
(Example)TEL:03-7832-4850 FAX:03-7832-4050
FAX:
If no fax, enter "None."
Address&Post code:
(required)