Secured Online Order Form
Submit your online order. Confirmations are sent within 1 to 12 hours.

CUSTOMER INFORMATION

First Name:*
Middle Initial:
Last Name:*
Nationality:*
Passport No. :*

The Japanese Government requires we ask for your passport number for the rental of our devices in Japan. You may also choose to provide us a drivers license or Federal Tax ID number.

Street Address:*
City:*
State/Province:*
Country:*
Zip/Postal Code:*
Home Phone:*
Business Phone:
E-mail:*
Email (Cc):
Business Name:
Business Address:

DELIVERY, PICKUP & RETURN INFORMATION

My Travel Date:*
Delivery Options:*
Airport Pickup Counters:*
Delivery Types:*
Flight Information:*
Flight No.*
Arrival Hour:*
Arrival Min:*
AM/PM:*

Airport pickup requires your 1st night's contact information . If staying at a Private Residence" or "Airbnb", indicate in the Hotel field. The full address and telephone number are required.

Hotel_Name:*
Contact Name:
Business_Name:
Street_Address:*
City/Township:*
State:*
Prefecture:*
U.S.A:
Phone:*
Postal Code:*
Zip Code:*
Phone No:*
Return Options:*
Airport Return Counters:*

Delivery of certain equipment to U.S.A. or International addresses may be limited. There is a possibility that return may be required prior to your departure from Japan. Please contact us if you have questions whether shipment is available to your location.

RENTAL INFORMATION

Rental Date:*
Return Date:*
Rental Plan:*
WiFi Router Rental:
Sim Card Options
iPhone Rental:
Android Rental:
Business Plans:
Business Plan GB requested:
Specialty Items :
Number Requested:*
Rental Plan (addition):
WiFi Router (addition):
Sim Card (addition):
iPhone Rental (addition):
Android Rentals (addition):
Business Plans (addition):
Business Plan GB requested:(1)
Specialty Items (addition):
Number Requested (addition):
Rental Date (addition):
Return Date (addition):
Special Requests:

PAYMENT INFORMATION

Payment Method:*
Card Type:*
Card Number:*
Expiration Month:*
Expiration Year:*
Security Code:*
Card Billing Address:*

Credit cards are processed on the day of shipment or delivery. Be be sure the card is active (not expired) from the rental date and for at least two months after the scheduled return date. Cards submitted not within the two month minimum may not be accepted. Please contact us if you have any concerns regarding this policy.

REFERRAL INFORMATION

How did you find us:*
Referred by:
Indicate, or other:
I have READ & AGREE with the Rental Terms and Conditions :*