KAKERU Flagship model order form Name of person who ordered Tel - - ※ Please enter a number where you can be reached during the day. Email Name of user User’s race experience Choose one Beginner Less than three years From three years to less than five years Five years or longer Will this KAKERU Flagship model be your first (second, etc.) racing wheelchair? Choose one First Second Third or more Requested measurement dates * Available 9:00-17:00 (closed on Saturday, Sunday, national holidays, and long holidays) Example: for July 1, 2014, enter “2014/07/01” 1st choice 2nd choice 3rd choice 4th choice Questions or comments
