Relocation Form Current Start Preview Complete Indicates required field Please read before filling in × Information message Please make sure of the following: This site of the inquiry form is managed and operated by our company. As our return E-mail is created only for responding to your inquiry, please do not use the information contained for other purposes. We may not be able to meet your request for a response by a specified date or in the case of urgent inquiries. Customer Information Customer Name Are You Moving Office Yes No Billing Information Billing Address Phone/Mobile E-mail Address Confirm your E-mail address by typing the same E-mail address below. Confirm email Relocation Information Preferred Pick up Date Preferred Pick up Time AM PM Security Clearance Required Yes No Machine Pick Up Information Pickup Address Staircase Yes No Site Details Opening Hours, Lift Access, Narrow Corridors, Parking (loading zones, loading docks, height restrictions, street parking. Pickup Contact Person Pickup Contact Person's Phone/Mobile Machine Delivery Information Delivery Address Staircase Yes No Site Details Opening Hours, Lift Access, Narrow Corridors, Parking (loading zones, loading docks, height restrictions, street parking. Delivery Contact Person Delivery Contact Person's Phone/Mobile Machine Information Product/Model Serial Number Software Support Required or Reconfiguration of Device/Workstation Yes No Pickup Contact Person's Phone/Mobile Accessories Location in Office I give my consent to FUJIFILM Business Innovation (Thailand) Co., Ltd. for the collection, use, storage and disclosure of my personal data for the specified purposes * according to Privacy Policy and I am the owner of the above personal data, I am over 10 years old, and not an incompetent or quasi-incompetent person. Privacy Policy
