Print The Order Form Below
To order by fax , print this form, fill it out, and send it to us
at the address or FAX number listed below.
E-mail address /
Phone number /
Order Item /
.Payment Method /
- Credit Card
- Wire Transfer
If you would like to order by E-mail ,
please send all necessary item.
1171-26 Yudairayama Hibara Kitashiobaramura
Yamagun, Fukushima Pref. 969-2701 Jaoan
Tel : +81-(0)241-23-5300 Fax : +81-(0)241-23-5301
E-mail : firstname.lastname@example.org