Domestic travel inquiries form

Domestic travel inquiries form

Inquiry Form

Various arrangement requests ※Required

Preferred date ※Required: Years Month Day Hour Minute

Total number of people ※Required: Example: Adults - X Men and X Women, Children - X, Infants - X (please include yourself)

Customer name ※Required: Example: Taro Sekietsu
*Please enter the name of the representative

Furigana Not applicable: Example: Kanetsu Taro

age: years old

Zip Code (Half-width alphanumeric characters): Example: 377-0002

Address ※Required: Example: 608-1, Nakamura, Shibukawa City, Gunma Prefecture

Phone ※Required (Half-width numbers): Example: 0279-22-2020

Desired location (eg from Takasaki station to Tokyo station)

E-mail Address ※Required

FAX: Example: 012-345-6789

Image authentication ※Required

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