FAX: 81-3-5447-1651
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 Order Form for the Technical Specifications & Dimension Diagrams
 on Plastics Injection Molding Machines
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 We order the above publication/CD/DVD as follows:

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 Publication,CD or both , DVD:  
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 Year/Edition of Publication/CD/DVD:

 Number of Copy   :
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 Name of Company & Department in Charge   :


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 Address of Company:

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 Phone Number:
 Fax Number:
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 E-mail Address:
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 Name of Staff in
 Charge for Order
 /Signature :
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 Method of Payment:
 (Refer to the copy of money deposit attached)
 Amount deposited :in Japanese Yen:

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 Your Order Number
 and Date of Order:
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 Remarks: 

 Request for Shipping the publication/CD: (if you have , specify):




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Information for placing the order:

 Language employed :Tables for specifications are prepared in 
 Japanese, however,comparative tables for Japanese-English are
 included in the publication.

 Our Bank account:
 MIZUHO BANK, Setagaya Branch, 
 Located at: Setagaya-ku, Tokyo, Japan

 Account No. 1187809
 Name of the account: Goshikaisya Kanagata-Tsushin-Sya
 Type of the account: Ordinary savings account

 Our address: 5-15-6, Minami-Azabu, Minato-ku, Tokyo
 Tel.:03-5447-1651

 Price for a copy of the publication or CD:

 Price per copy of the publication/CD-ROM is the same, 18,900 yen
 International shipping charge: 2,500yen
 Total amount to be sent: 21,400yen per copy (including tax)

Order both for the publication and CD: 30,000 yen per set (including tax)
International shipping charges: 3,500yen
Total amount to be sent: 33,500 yen per set (including tax)

Price for DVD: 73,500 yen per copy
International shipping charge: 2,500yen
Total amount to be sent: 76,000yen per copy (including tax)


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