แบบฟอร์มการได้มาซึ่งฐานลูกค้าออนไลน์

Name (Full Name)	Example : Wong Xiao Ming
Gender	MaleFemale
Shipping Address
Contact Number	Please input numerical characters only
Email Address	Example : jewel-cafe-au2@crane-a.co.jp ※Kindly make sure that the email has not gone to 'Spam'and 'Junk Mail' folder after applying.
Retype Email Address	Ensure that you’ve entered your email address correctly, please re-enter in this field.
Upload your item image	※Image format : ｊpg , gif , png ※Maximum 5MB for each image size
Brand Name	Example: White Gold Ring, ROLEX
Item description	※Please use ‘Photo Upload’ Method if you are unsure about product name/serial. Kindly describe item name and date of purchase in details
Date of Purchase	Example: Year 1998, May
Condition of Item	Example: 9/10
Preferred method of contact	TELE-mailWhichever
Promotion Update	Agree to receive promotion updates from Jewel Cafe. We will notify you once we are having any exclusive promotion.
Notes & Remarks	※We encourage you to describe your item condition in details. ※If you wish to estimate more items, kindly describe them here.

I certify that I am 21 years of age or older. (You must be at least 18 years old for using this service)