Supplier Application Form​ ​

Please note

  • *Marked items are required to entry.
  • Please fill in the necessary items and push the confirmation button.
  • Please leave the column of "Japanese Kana" blank.
  • Please enter phone number in half-width numbers.

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After confirming, please click the "send" button.

Company Name
Japanse Kana
Head Office
Representative Title
Sales Contact
Factory/Office Name
Phone Number
Job Title
Japanse Kana
E-Mail Address


E-Mail Address


About us
Capital​ ​(One million Japanese Yen)
Date of Establishment​ ​
Number of Employees​ ​
Recent 3 years' Results

Settlement Period​ ​(Year Month) Sales Amount​ ​(One million Japanese Yen) Operating Income​ ​(Thousand Japanese Yen) Ordinary Income​ ​(Thousand Japanese Yen)




Major Shareholders

Shareholder Name Ratio(%)

Major Sales Item Status

Sales Item Sales Amount​ ​(One million Japanese Yen) Ratio(%) Major Customers

Factory Outline

Factory/Office Name Address Production Item

Certifications Acquired
(ISO / QS 9000 / IATF etc.)

Certifications Acquired Certification Acquisition Date​ ​ Acquisition Range

Products that you wish to have transaction with our company
PR Point
​ ​(Please comment on the characteristics of your company, your strength etc. within 200 letters.)
Price Competitiveness
Company Information etc. attached

Privacy Policy
Regarding the handling of personal information, we will manage it based on our "privacy policy".