Ebisu circuit Supporter registration Form

Please push the Green button after filling out the below.


Privacy policy
In ebisu circuit co.,ltd. to comply with the Code and other laws and regulations regarding personal information,and care is taken to ensure the protection of important personal information of our customers.
About the collection of personal information(Such as customer information such as commodities trading name, address and credit card information and e-mail address that you obtained)
Our company may collect personal information to the extent necessary in the following cases.
Our company can disclose or provide personal information to third parties retrieved from the customer is not available.In accordance with the various terms in compliance with the Personal Information Protection Act, confirm that accompany the Personal Data Protection Law and our regulations, the handling of personal information has been paying close attention.
Ebisu circuit.,co.ltd to comply with the Code and other laws and regulations regarding personal information,and care is taken to ensure the protection of important personal information of our customers.

Currency (ex:$・¥....)
Donate gofundme(Crowdfunding)
MUFG Bank,LTD(Bank transfer)
Paypal
Amount of the donation
Select Individual
Corporate
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Name
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Address
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Phone Number
Email address
Message
Would it be alright to post your name to Ebisucircuit support Yes
No
Desired Name for the Name-board
Use Logo(Please attach) Yes
No
添付ファイル 1000KB以下
Agree for the privacy policy Yes
No


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