Contract Procedures

    Application Form

    Business Name Required

    Business Address Required

    To Whom It May Concern Required

    Contact Information (Phone Number) Required

    Contact Information (Email Address) Required

    Email address for Scanat administrator account ( Required )

    If you have any other email addresses that require account registration, please enter them here.

    Device Rental Request (Type, Quantity)

    If the shipping address for the device differs from the above address, please enter it here.

    Please select a payment method. Required

    Please select a plan (tax included) Required

    Desired Start Month ( Required )

    ※ " Scanat " counts from the 1st to the last day of the month as one month. Even if you start using the service mid-month, you will be charged for one full month.

    How I learned about Scanat Required


    Name of Referrer (excluding our sales representatives) Required

    ※ If there is no applicable person or if it is unknown, please enter "None."

    Notes

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