Consent with Terms & Conditions of DBCR service, I apply for the service as follows. At the same time, please read the Important Notice carefully.
First name ※Required
Family name ※Required
gender MaleFemaleOther
age
Intention for tire purchase commission (Please notice if you want us to purchase the tires on your behalf) YesNo
Desired tire size ※Required
Desired tire brand, type etc
Car manufacturer
Car brand
The year of car manufactured
Other characteristics
Desired receiving method ※Required
Address ※Required HomeBusiness
ZIP code ※Required
Address ※Required
e-mail address ※Required
e-mail address (Confirmation) ※Required
Phone number ※Required
Question and request
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※The personal information inputted to this form will be carefully archived and used only for offering service and improving service of the shop under the law, rules and sprit of “personal information protection”
Address4-22-18 Nakanokamicho, Hachioji-shi, Tokyo 192-0041TEL.042-649-7798FAX.042-649-7195e-mail. info@show-tire.com