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Application inquiry

Application inquiry

Division ※required
The name ※required
Example) Taro Yamada
Furigana ※required
Example) Yamada Taro
Sex
Age ※required
Year
Address ※required
 
Phone number ※required
Example) 012-345-6789 ※A cell-phone is possible
FAX number
Example) 012-345-6789
E-mail address ※required


※I reinput it for confirmation
Die production engineer ※required
Desired motive and appeal point/inquiry contents
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