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Kuchiire Doll Application

Notice

This is the application form for the Kuchiire doll.
After sending the necessary information, please remit the initial charge and shipping fee by postal transfer. For information on postal transfer, please confirm "Inquiries" to "About postal transfer". The application will be completed when the payment is confirmed. We will notify you by email when we are ready to ship the doll.
 
 

When applying

■ When applying, please confirm the Privacy Policy and fill out the inquiry form only upon agreement.
■ Be sure to enter a valid phone number (home or mobile phone) in the phone number field.
■ It may take time for us to reply, so please contact us by phone if you are in a hurry.
■ Please check your settings (spam settings), etc. so that you can receive reply emails.
■ If you do not receive a reply from us, we apologize for the trouble and ask that you please contact us again.

Kuchiire Doll Application

Prayer matters ※Required
Company Name
Only when applying as a company
Furigana
Name ※Required
Example: Taro Yamada
Furigana ※Required
Example) Taro Yamada
Sex
Date of Birth ※Required
Years Month Sun 
age ※Required
age
Zip Code ※Required
Example) 012-3456
Prefectures ※Required
Municipality ※Required
Street number, shop name, etc. ※Required
Phone ※Required
Example) 012-345-6789 * Mobile phones are available
FAX
Example: 012-345-6789
E-mail address ※Required


* Re-enter for confirmation
Remarks
Please fill in here only if you want to send the dolls to different destinations.
Destination name
Address
Postal Code 
Phone
Araki Jinja
〒612-0805
12-3, Fukakusakaidoguchicho, Fushimi-ku, Kyoto-shi, Kyoto
TEL.075-643-0651
FAX: 075-644-0170
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