Appointment

Name（required）

Visit
New Repeater

Membership Number

Cell phone Number
Example: 080-xxxx-3645

Email（required）
Example:sample@XXXX.ne.jp

Treatment parts（required）
Hand nail Toe nail

Choice of exchange nails（required）
Remove your hand nails No need to remove your hand nails Remove your toe nails No need to remove your toe nails

Choose for hand nail staff
DACCI IE AKIRA LEINA FREE

Choose for toe nail staff
DACCI IE AKIRA LEINA FREE

Please fill in the menu of your choice（required）
(Please confirm about details from menu pages and confirm about campaigns from the news list)

Preferred date and time (Starting time)（required）：First choice
Month -- January February March April May June July August September Octorber November December Day -- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Time --:-- 11:00 11:30 12:00 12:30 13:00 13:30 14:00 14:30 15:00 15:30 16:00 16:30 17:00 17:30 18:00 18:30 19:00 19:30 20:00 20:30

Preferred date and time (Starting time)（required）：Second choice
Month -- January February March April May June July August September Octorber November December Day -- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Time --:-- 11:00 11:30 12:00 12:30 13:00 13:30 14:00 14:30 15:00 15:30 16:00 16:30 17:00 17:30 18:00 18:30 19:00 19:30 20:00 20:30

Preferred date and time (Starting time)（required）：Third choice
Month -- January February March April May June July August September Octorber November December Day -- 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Time --:-- 11:00 11:30 12:00 12:30 13:00 13:30 14:00 14:30 15:00 15:30 16:00 16:30 17:00 17:30 18:00 18:30 19:00 19:30 20:00 20:30

Notes