Membership Application

Membership Application

***Please note that individuals and retailers not engaged in fashion industry are unqualified to register as our member.


Company Name


ex: NEGORO Company

TEL


ex: 06-6536-0000

E-Mail


ex: info01@pc-beans.jp

Department


ex: Web Services Department

Country


ex: Korea

Address



Zip Code


ex: 536-0025

Your Name



Company Representative's Name



Date of Birth


Main Current Supplier
Which category best describes your shop?



Select from the drop-down menu.

What kind of items do you sell the most of?


Foundation Year
Establishment Year

Annual Revenue

Approx.
Shop Holidays
ex: Every Sundays

Number of Shops


Retail Space

Number of Employees


Shop Type
ex: Boutique, Online Shop

Which store will you mostly visit?


Choose from the drop-down menu.
Store Facade Image
Store Interior Image
Face Image
Any Comments