CSJ USB Application Form

1. Usage Type
2. User
※ If the application is from a laboratory, use the manager's name.
※ When applying for personal use, enter a home address. In other cases please use your organization's address.
The Student use is for personal use only.
3. Contact Representative

Input if the person contacting us is different from the primary user above. Check 'Same to user' if same.

4. Subscriber
'The subject of the contract' is the registered holders in the contract form.
The organization name should be assigned as the registered holders in the contract form.

Input if the subscriber entering the contract is different from the primary user above. Check 'Same to user' if same.

5. Billing Name
6. Payer Information

Input if different from the Billing Name above. Check 'Same to billing name' if same.

7. Delivery Address

Input if different from the Contact Details above. Check 'Same to user' if same.