□ Please print this page out and fill out required items and send by fax. □
Order Form for Uniform
Name: Mr./ Ms.
Date
/
/
Address:
Telephone number:
 Fax number:
E-mail address:
Please fill in the blanks with your card information　(Visa/Master/JCB/Amex)
Card:
 Expiring date:
Card Number:
 Holder's name:

Embroidery

Material
Size
Name
Embroidery
on chest
Embroidery
on sleeve
Label
Quantity























Fax number for order
Tokyo head office:+81-3-3730-5336