Inquiries form

Inquiries form

Fill out all necessary information and check/transmit the form.
Fill out all fields with[*]mark.
If you are an individual customer, please put “Individual” to the fields for Company name and Attribution.

  • Entry screen
  • Checking entered contents
  • Entry complete
Title of Inquiry[*]
Content[*]
Furiganaセイ:(全角カナ)  メイ:(全角カナ)
Name[*]姓:  名:
Company name/
school name[*]
Attribution/
Department, Group
Business[*]
  • Manufacturer (semiconductor)
  • Manufacturer (liquid crystal)
  • Manufacturer (automobile)
  • Manufacturer (device)
  • Manufacturer (physical and chemical science)
  • Manufacturer (others)
  • Design, assembly
  • Trading company (wholesale)
  • Trading company (industry)
  • Trading company (physical and chemical science)
  • Research and development group
  • Universities, educational groups
  • Civil services
  • Others
Address Line 1(半角英数)
Address Line 2(半角英数)
City
State/Provimce/Region(半角英数)
Country[*]
Postal/Zip Code(半角英数)
Phone number[*] - - (半角数字)
Fax number - - (半角数字)
Mail address[*](半角125文字以内)
(確認用)
  • Want to receive the latest information from Chuo Precision Industrial Co., Ltd.
  • Do not receive the latest information from Chuo Precision Industrial Co., Ltd.
Privacy Policy[*]
  • I agree.