Please print out and use it. |
CROSSWING ORDER FORM |
FAX 81-864-35-9150 | |||||
ITEM NUMBER | DESCRIPTION | QUANTITY | PRICE EACH | TOTAL PRICE | |
SUBTOTAL | |||||
SHIPPING | |||||
TOTAL DVE |
ZIP | CUSTOMER NO | |||
ADDRESS | ||||
NAME | AGE | |||
TEL | FAX | |||
PAYMENT | VISA ・ MASTER ・ JCB ・ AMEX | ||
CARD NO | - - - | GOOD THRU | M YEAR |
1-4-23 HAMANOCHAYA KURASHIKI-CITY OKAYAMA JAPAN TEL 81-864-25-4511 FAX 81-864-35-9150 |
Please fax 81-864-35-9150 after printing out this page and filling in a necessary matter at the fax order. |