Confirm your donation (monthly)

Amount※
Donor information※	Last name: First name: Company name:
Address※	Address type: Postal code in Japan： Prefecture： City: Address lines: or overseas donors, please write the full address below including the country name.
Phone number※
E-mail:※
Preferred method of receiving a receipt※
May we post your name as a donor on our promotional materials?※
Remarks

Please click “SUBMIT” to confirm and proceed.
A confirmation e-mail will be sent to the registered e-mail address upon returning to the shop site after the transaction.