Applicant Information

Payment Information

Credit card Information

Confirmation of input information

Application accepted completion


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* are required field.

Applicant Information

Name * First    Family 
Postal code *  -    
State / Province *
City *
Example: Minato-ku
Street *
Example: 6-10-11 Minami-Aoyama
Building
Example: Wesley Center, Room 203
Building
Street *
City *
State / Province *
Postal code *
Country *
Date of birth *  /  /
Sex *
Phone *
Email address *
Please enter again to reconfirm.
Member code

Payment Information

Amount *  Yen
The minimum donation is 10,000 Yen.
Payment style *

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Credit card Information

We accept the credit cards with the following brand marks.

VISA

mastercard

JCB

AMERICAN EXPRESS

Dinners Club
Card number *
Please do not use hyphens or spaces.
Expire date *  Month  Year
Security code *   Security Code
Convenience *

ご利用されるコンビニの変更はできませんのでご注意ください。

Bank code *

振込先は決済代行会社「みずほファクター」と表示されます。
別途振込手数料がかかります。

Bank user_name *
全角カタカナで入力して下さい。

ペイジーが選択されています。

PayPalが選択されています。

WebMoneyが選択されています。

銀行振込が選択されています。

郵便振替が選択されています。

Please feel free to send us a message.

The personal information of the applicant, is not used for applications other than those related to MOA MUSEUM MEMBERS CLUB.

On the Specified Commercial Transactions

Operator

Business Operator MOA MUSEUM OF ART
Address
Representative
Homepage Address

Inquiries, Payment Processing, Opening Times

Inquiries
Payment Processing
Opening Times

Sales price, Postage costs and other fees

Sales price This question item doesn’t correspond to donation.
Please set the amount of money on your own donation.
The contributions, large or small, are accepted.
Input or choose the amount.
Sales amount This question item doesn’t correspond to donation.
Postage・cash on delivery handling charges etc. This question item doesn’t correspond to donation.
Application deadline This question item doesn’t correspond to donation.

Payment method, Handling and Cancellations

Payment method We accept credit card and the other payment option that you can choose on this form.
Payment period This question item doesn’t correspond to donation.
Product Handling period This question item doesn’t correspond to donation.
Faulty products This question item doesn’t correspond to donation.
Returns and Cancellations As a general rule, we don’t accept your cancellation.

Donation system provider

Business Operator curioworks inc.
Homepage Address kifu.fm