Customer Inquiry Form

Inquiry details: Please select and enter the details of your inquiry.

Inquiry category
(Required)

If you select Agricultural Chemicals, Fine Chemicals, Curing Agents, Other Products, or R&D, please be sure to enter you company or organization name in the Name and contact details column.
Inquiry details

Name and contact details

Name
(Required)
Country
(Required)
Affiliation
(company or organization name)
Required depending on inquiry category**
E-Mail Address
(Required)

*One-byte characters: Please accurately write your e-mail address.
E-mail address for confirmation
(Required)

*Please use the same e-mail address as above.

Mobile phones may not be able to receive e-mail replies sent by the Company.
If using a personal computer, please enter your PC e-mail address.

**If you select a category related to product information (Agricultural Chemicals, Fine Chemicals, Curing Agents, Other Products, or R&D) from the inquiry categories, please be sure to enter your company or organization name.