Order Form to Subscribe to Cyber Shipping Guide

Annual subscription fee is set as follows:

Number of IDs
1 ID
Group

Annual Fee in Yen

25,200

50,400
ID means a pair of user name and password. Every user is required to have 1 ID.

To subscribe,

1. Fill out the form below. Fields marked with (*) are required to enter.
2. Print this page.
3. Send it to us by facsimile at number 81-3-3435-7896.

Please note that this page does not contain Submit button. For security reason, we avoid transmitting this form via the Internet. Please use facsimile instead.

(*)Name:

(*)E-Mail:

(*)Phone:

(*)Facsimile:

(*)Organization:

(*)Devision & Title

(*)Address:

Country
Postal Code

(*)IDs:

1 ID Group

(*)Credit Card:

VISA Master Card AMEX

(*)Card Number:

(*)Expiration Date:

(mm/yy)

Owner:

(Fill this field only if you are not the owner of the card)

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