Department Inquiry Form | Contact | Mitsubishi Gas Chemical Company, Inc.

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href="/eng/">EN</a></li> </ul> </li> </ul> </div> </dd> </dl> </nav> </div>  </header> <main id="pageBody" role="main">  <nav id="topicPathArea">  <div class="contentsInner" aria-label="Breadcrumb trail"> <ol id="topicPath"> <li><a href="/eng/">Home</a></li> <li><a href="/eng/inquiry/">Contact</a></li> <li>Department Inquiry Form</li> </ol> </div>  </nav>  <div id="contentsArea" class="contentsInner setLocalMenu">  <div id="contents"> <section> <h1 class="ttl-h1">Department Inquiry Form</h1> <p>Please fill in the required information in the form below, read the confirmation regarding the handling of personal information, and check the " I accept the terms and conditions concerning the handling of personal information.". After that, please press the "Confirm" button at the bottom of the page.</p> <div> <ul class="form-flow"> <li class="act"> <span class="num">1</span> <span>Form</span> </li> <li> <span class="num">2</span> <span>Confirmation</span> </li> <li> <span class="num">3</span> <span>Complete</span> </li> </ul> </div> <div><span class="icon-required">Required</span>fields must be filled out.</div> <form action="index.php" method="post" name="me_mailform" id="form" enctype="multipart/form-data"> <input type="hidden" name="_step" value="confirm"><input type="hidden" name="_token" value="b7ff8030a9ea8e3f6a682c7f17b019507bc5c854"><table class="table-default spaceMT" role="table" aria-label="Department Inquiry Form Table" summary="Department Inquiry Request Form Table"> <tbody> <tr> <th class="ttl" scope="row"><span class="icon-required">Required</span>MGC Department</th> <td> <select name="division"> <option value="">-</option> <optgroup label="Green Energy & Chemicals Business Sector"> <option value="Green Energy & Chemicals Business Sector, C1 Chemicals Division" >C1 Chemicals Division</option> <option value="Green Energy & Chemicals Business Sector, High-performance Products Division" >High-performance Products Division</option> <option value="Green Energy & Chemicals Business Sector, Life Sciences Division" >Life Sciences Division</option> <option value="Green Energy & Chemicals Business Sector, Planning & Development Division" >Planning & Development Division</option> </optgroup> <optgroup label="Specialty Chemicals Business Sector"> <option value="Specialty Chemicals Business Sector, Inorganic Chemicals Division" >Inorganic Chemicals Division</option> <option value="Specialty Chemicals Business Sector, Engineering Plastics Division" >Engineering Plastics Division</option> <option value="Specialty Chemicals Business Sector, Optical Materials Division" >Optical Materials Division</option> <option value="Specialty Chemicals Business Sector, Electronics Materials Division" >Electronics Materials Division</option> <option value="Specialty Chemicals Business Sector, Oxygen Absorbers Division" >Oxygen Absorbers Division</option> <option value="Specialty Chemicals Business Sector, Planning & Development Division" >Planning & Development Division</option> </optgroup> <optgroup label="Research & Development Division"> <option value="Research & Development Division, New Business Development Department" >New Business Development Department</option> </optgroup> <optgroup label="Administratine & Personnel Division"> <option value="Administratine & Personnel Division, Public Relations Department" >Public Relations Department</option> </optgroup> </select> </td> </tr> <tr> <th class="ttl" scope="row"><label for="name"><span class="icon-required">Required</span>Name</label></th> <td><input type="text" name="name" id="name" value="" class="w45 sp-wMax"> </td> </tr> <tr> <th class="ttl" scope="row"><label for="company"><span class="icon-required">Required</span>Company</label></th> <td><input type="text" name="company" id="company" value="" class="w45 sp-wMax"> </td> </tr> <tr> <th class="ttl" scope="row"><label for="organicName"><span class="icon-any">Optional</span>Department</label></th> <td><input type="text" name="dept" id="organicName" value="" class="w100"> </td> </tr> <tr> <th class="ttl" scope="row"><label for="country"><span class="icon-any">Optional</span>Country</label></th> <td><input type="text" name="country" id="country" value="" class="w45 sp-wMax"> </td> </tr> <tr> <th class="ttl" scope="row"><label for="state"><span class="icon-any">Optional</span>State or Province</label></th> <td><input type="text" name="state" id="state" value="" class="w45 sp-wMax"> </td> </tr> <tr> <th class="ttl" scope="row"><label for="local"><span class="icon-any">Optional</span>City</label></th> <td><textarea type="text" name="city" id="local"></textarea> </td> </tr> <tr> <th class="ttl" scope="row"><label for="street"><span class="icon-any">Optional</span>Street</label></th> <td><input type="text" name="street" id="street" value="" class="w45 sp-wMax"> </td> </tr> <tr> <th class="ttl" scope="row"><label for="postcode"><span class="icon-required">Required</span>Zip or Postal code</label></th> <td><input type="text" name="zipcode1" id="postcode" value=""> </td> </tr> <tr> <th class="ttl" scope="row"><label for="phone"><span class="icon-required">Required</span>TEL</label></th> <td><input type="text" name="phone1" size="7" id="phone" value="" class="w25-Per"> - <input type="text" name="phone2" size="10" value="" class="w25-Per"> - <input type="text" name="phone3" size="10" value="" class="w25-Per"> </td> </tr> <tr> <th class="ttl" scope="row"><label for="fax"><span class="icon-any">Optional</span>FAX</label></th> <td><input type="text" name="fax1" size="7" id="fax" value="" class="w25-Per"> - <input type="text" name="fax2" size="10" value="" class="w25-Per"> - <input type="text" name="fax3" size="10" value="" class="w25-Per"> </td> </tr> <tr> <th class="ttl" scope="row"><label for="mail"><span class="icon-required">Required</span>E-mail address</label></th> <td><input type="text" name="email" id="mail" value="" class="w100"> </td> </tr> <tr> <th class="ttl" scope="row"><label for="question"><span class="icon-required">Required</span>Messages</label></th> <td><textarea name="comment" rows="5"></textarea> </td> </tr> </tbody> </table> <div class="box-colorD spaceLT"> <p>The personal information you provide will be used only to the extent necessary to respond to your inquiries based on your consent, and will not be used for any other purpose. Depending on the nature of the inquiry, the personal information you provide may be disclosed to relevant MGC Group companies, which may then respond directly to the inquiry. Also in such cases, the personal information you provide will be used only to the extent necessary to respond to your inquiries, and will not be used for any other purpose. For more information on MGC's policy on protection of personal information, please see the <a href="/eng/privacy/" class="inline">Privacy Policy</a>.<br>SSL (an encrypted transmission protocol) is used to ensure the secure transmission of the information entered on this inquiry form.</p> </div> <p class="form-checkbox spaceMT"> <input type="checkbox" name="agree" value="agree" id="agree" > <label for="agree"><span class="icon-required">Required</span>I accept the terms and conditions concerning the handling of personal information.</label> </p> <div class="confirmation-btn-area"> <div class="confirmation-btn"> <input type="submit" name="button btn-primary" id="button" value="Confirm" class="confirmation-icon"> </div> </div> <input name="actionMode" type="hidden" value="confirm"> </form> <p class="text-right"></p> </section> </div>   <aside id="localMenu"> <nav> <dl> <dt class="lm-categoryTtl"><a href="/eng/inquiry/">Contact</a></dt> <dd> <ul class="lm-list"> <li><a href="/eng/inquiry/media/"><span>Media and Press Inquiries</span></a></li> <li><a href="/eng/inquiry/ir/"><span>Stock and Investors Inquiries</span></a></li> <li><a href="/eng/inquiry/request/"><span>Information Request Form</span></a></li> <li><a href="/eng/inquiry/division/"><span>Department Inquiry Form</span></a></li> <li><a href="/eng/corporate/compliance/contact.html">Compliance Hotline</a></li> <li><a href="/eng/sustainability/society/humanright/contact.html">Human Rights Hotline</a></li> <li><a href="/eng//inquiry/products/"><span>Product Inquiry</span></a></li> <li><a href="/eng/inquiry/other/"><span>General Inquiry Form</span></a></li> </ul> </dd> </dl> </nav> </aside>  </div>  </main> <footer id="footer"> <div id="footerArea">  <div class="contentsInner ftrInner"> <div id="ftrMenu-block" class="col-2 col-clm1-2"> <div id="ftr-logo"> <a href="/eng/"><img src="/eng/shared/img/ftr-logo.svg" alt="MGC Group logo"></a> <ul class="ftr-sns"> <li><a href="https://www.youtube.com/channel/UCRVaVQrnl8KbJD1hafPJ2ag" target="_blank"><img src="/eng/shared/img/youtube_icon.png" alt="youtube logo"></a></li> </ul> </div> <div id="ftrSubMenu"> <ul> <li><a href="/eng/sitemap.html">Sitemap</a></li> <li><a href="/eng/privacy/">Privacy Policy</a></li> <li><a href="/eng/sns_policy.html">MGC鈥檚 Social Media Policy</a></li> </ul> <ul> <li><a href="/eng/site.html">Terms of Use</a></li> <li><a href="/eng/accessibility.html">Web Accessibility Policy</a></li> </ul> </div> </div> </div>  <div id="ftr-copyright"><div class="contentsInner"><p>Copyright 漏 MITSUBISHI GAS CHEMICAL COMPANY, INC. 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Department Inquiry Form | Contact | Mitsubishi Gas Chemical Company, Inc.