Inquiry Form

All fields are required to be filled.


Your name

Your e-mail address

Your tel number

※Numbers with "-".
※Please provide us a number that we can reach you, if you don't have any - the broken phone number is sufficient

The Store you like to Visit

Carrier

docomoauSoftBankY!MobileRakuten mobileothers

Model

*Model that does not appear on the list can not be repaired.

Code

Color of the frame

*Select one which is close to yours.

Color of the back panel

*Select one which is close to yours.

Malfunction

*If you fall under "others", please write in detail below.

Status of breakage and malfunction, such reasoning

How have you found our Shop?
Serched on the search engineSNS such as Twitter, Instagram, etc.RepeatIntroduction from acquaintancesStore sign boardBanners on the other website

On which device have you visited our site?
PCAndroid smartphoneiPhone/iPadothers


Confirm the inquiry contents above, confirm the policy concerning handling of personal information, agree, inquire.(Check it and you can send it)


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