RequireName

RequireEmail address

RequireEmail address (reconfirm)

TEL

RequireType of contacts

About Kokusai dori shopping streetAbout Smile TagAbout transit mallAbout 10,000 eisa groupAbout registlation of member's shopAbout registlation of performer at transit mallAbout coverageOthers

RequireContents of contact

Please fill out the content od contact.
Please make sure to fill out group name and content of performance about the registlation of transit mall performer.