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Enter your information and inquiry.
Make sure to enter the data in the item with an asterisk (*). Do not use special characters.

Customer Information Entry

Customer Information

Name (Given name)* Ex: Ichiro
Name (Family name)* Ex: Suzuki
Company* Ex: Oriental Motor Co., Ltd
Site Name Ex: Tokyo office
Name of Department or Division Ex: Marketing HQ
Job Title Ex: Deputy manager
Type of Business
Type of Job Category
Postal Code* Ex: 100000
Address* Ex: 1-4-25, Kouraku, Bunkyo-ku, Tokyo
Telephone Number* Ex: 123456789012
FAX Number Ex: 123456789012
Email* Ex: user@user.co.jp

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