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お問い合わせ - Aromatic Chemicals - 三菱ガス化学株式会社
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以下のフォームに必要事項をご記入いただき、送信してください。<br>内容を確認の上、担当者より折り返しご連絡いたします。<br>お問い合わせの内容によってはご回答に日数・時間を要する場合がございますので、あらかじめご了承ください。 </p> <form action="https://aromatics.mgc.co.jp/inquiry/confirm/" id="inquiry-form" method="post" enctype="multipart/form-data" novalidate> <input type="hidden" name="mw-wp-form-form-id" value="6"><input type="hidden" name="mw_wp_form_token" value="511b9e1c885e2ef525fa08fba811c6a6948b91e828499b565a90000d6bad71ba"> <ul class="list-form"> <li> <dl> <dt class="label-required"> お問い合わせ種別 <span>※必須</span> </dt> <dd class="inquiry-radios list-form_radio"> <span class="mwform-radio-field horizontal-item"> <label for="type-1"> <input type="radio" name="type" value="サンプル資料" id="type-1" class="required" /> <span class="mwform-radio-field-text">サンプル資料</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="type-2"> <input type="radio" name="type" value="資料請求" id="type-2" class="required" /> <span class="mwform-radio-field-text">資料請求</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="type-3"> <input type="radio" name="type" value="お見積り" id="type-3" class="required" /> <span class="mwform-radio-field-text">お見積り</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="type-4"> <input type="radio" name="type" value="その他" id="type-4" class="required" /> <span class="mwform-radio-field-text">その他</span> </label> </span> <input type="hidden" name="__children[type][]" value="{"\u30b5\u30f3\u30d7\u30eb\u8cc7\u6599":"\u30b5\u30f3\u30d7\u30eb\u8cc7\u6599","\u8cc7\u6599\u8acb\u6c42":"\u8cc7\u6599\u8acb\u6c42","\u304a\u898b\u7a4d\u308a":"\u304a\u898b\u7a4d\u308a","\u305d\u306e\u4ed6":"\u305d\u306e\u4ed6"}" /> </dd> </dl> </li> <li> <dl> <dt class="label-required"> お問い合わせ先 <span>※必須</span> </dt> <dd class="inquiry-radios list-form_radio"> <div class="l-select-form l-select-form01"> <p class="pseudo-select_output form-switch__button switch__button01"><span>選択してください</span></p> <div class="list-form_pseudo-select form-switch__menu switch__menu01" style="display: none;"> <span class="mwform-radio-field horizontal-item"> <label for="base-1"> <input type="radio" name="base" value="日本" id="base-1" class="required" /> <span class="mwform-radio-field-text">日本</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="base-2"> <input type="radio" name="base" value="中国" id="base-2" class="required" /> <span class="mwform-radio-field-text">中国</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="base-3"> <input type="radio" name="base" value="タイ" id="base-3" class="required" /> <span class="mwform-radio-field-text">タイ</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="base-4"> <input type="radio" name="base" value="シンガポール" id="base-4" class="required" /> <span class="mwform-radio-field-text">シンガポール</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="base-5"> <input type="radio" name="base" value="ドイツ" id="base-5" class="required" /> <span class="mwform-radio-field-text">ドイツ</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="base-6"> <input type="radio" name="base" value="アメリカ" id="base-6" class="required" /> <span class="mwform-radio-field-text">アメリカ</span> </label> </span> <input type="hidden" name="__children[base][]" value="{"\u65e5\u672c":"\u65e5\u672c","\u4e2d\u56fd":"\u4e2d\u56fd","\u30bf\u30a4":"\u30bf\u30a4","\u30b7\u30f3\u30ac\u30dd\u30fc\u30eb":"\u30b7\u30f3\u30ac\u30dd\u30fc\u30eb","\u30c9\u30a4\u30c4":"\u30c9\u30a4\u30c4","\u30a2\u30e1\u30ea\u30ab":"\u30a2\u30e1\u30ea\u30ab"}" /> </div> </div> </dd> </dl> </li> <li> <dl> <dt class="label-required"> 氏名 <span>※必須</span> </dt> <dd> <input type="text" name="contact_name" class="required" size="60" value="" placeholder="三菱太郎" /> </dd> </dl> </li> <li> <dl> <dt>職種・業種</dt> <dd> <input type="text" name="industry" size="60" value="" /> </dd> </dl> </li> <li> <dl> <dt class="label-required"> 会社名 <span>※必須</span> </dt> <dd> <input type="text" name="company" class="required" size="60" value="" placeholder="三菱ガス化学株式会社" /> </dd> </dl> </li> <li> <dl> <dt> 部署名 </dt> <dd> <input type="text" name="department" size="60" value="" placeholder="部署名を入力してください" /> </dd> </dl> </li> <li> <dl> <dt> 郵便番号 </dt> <dd style="width: 20em;"> <input type="text" name="postcode" size="7" value="" placeholder="1008324" /> </dd> </dl> </li> <li> <dl> <dt class="label-required"> 都道府県 <span>※必須</span> </dt> <dd class="inquiry-radios list-form_radio"> <div class="l-select-form l-select-form02"> <p class="pseudo-select_output form-switch__button switch__button02"><span>選択してください</span></p> <div class="list-form_pseudo-select form-switch__menu switch__menu02" style="display: none;"> <div class="pseudo-select_wrap"> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-1"> <input type="radio" name="prefectures" value="北海道" id="prefectures-1" class="required" /> <span class="mwform-radio-field-text">北海道</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-2"> <input type="radio" name="prefectures" value="青森県" id="prefectures-2" class="required" /> <span class="mwform-radio-field-text">青森県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-3"> <input type="radio" name="prefectures" value="岩手県" id="prefectures-3" class="required" /> <span class="mwform-radio-field-text">岩手県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-4"> <input type="radio" name="prefectures" value="宮城県" id="prefectures-4" class="required" /> <span class="mwform-radio-field-text">宮城県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-5"> <input type="radio" name="prefectures" value="秋田県" id="prefectures-5" class="required" /> <span class="mwform-radio-field-text">秋田県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-6"> <input type="radio" name="prefectures" value="山形県" id="prefectures-6" class="required" /> <span class="mwform-radio-field-text">山形県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-7"> <input type="radio" name="prefectures" value="福島県" id="prefectures-7" class="required" /> <span class="mwform-radio-field-text">福島県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-8"> <input type="radio" name="prefectures" value="茨城県" id="prefectures-8" class="required" /> <span class="mwform-radio-field-text">茨城県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-9"> <input type="radio" name="prefectures" value="栃木県" id="prefectures-9" class="required" /> <span class="mwform-radio-field-text">栃木県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-10"> <input type="radio" name="prefectures" value="群馬県" id="prefectures-10" class="required" /> <span class="mwform-radio-field-text">群馬県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-11"> <input type="radio" name="prefectures" value="埼玉県" id="prefectures-11" class="required" /> <span class="mwform-radio-field-text">埼玉県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-12"> <input type="radio" name="prefectures" value="千葉県" id="prefectures-12" class="required" /> <span class="mwform-radio-field-text">千葉県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-13"> <input type="radio" name="prefectures" value="東京都" id="prefectures-13" class="required" /> <span class="mwform-radio-field-text">東京都</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-14"> <input type="radio" name="prefectures" value="神奈川県" id="prefectures-14" class="required" /> <span class="mwform-radio-field-text">神奈川県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-15"> <input type="radio" name="prefectures" value="新潟県" id="prefectures-15" class="required" /> <span class="mwform-radio-field-text">新潟県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-16"> <input type="radio" name="prefectures" value="富山県" id="prefectures-16" class="required" /> <span class="mwform-radio-field-text">富山県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-17"> <input type="radio" name="prefectures" value="石川県" id="prefectures-17" class="required" /> <span class="mwform-radio-field-text">石川県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-18"> <input type="radio" name="prefectures" value="福井県" id="prefectures-18" class="required" /> <span class="mwform-radio-field-text">福井県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-19"> <input type="radio" name="prefectures" value="山梨県" id="prefectures-19" class="required" /> <span class="mwform-radio-field-text">山梨県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-20"> <input type="radio" name="prefectures" value="長野県" id="prefectures-20" class="required" /> <span class="mwform-radio-field-text">長野県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-21"> <input type="radio" name="prefectures" value="岐阜県" id="prefectures-21" class="required" /> <span class="mwform-radio-field-text">岐阜県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-22"> <input type="radio" name="prefectures" value="静岡県" id="prefectures-22" class="required" /> <span class="mwform-radio-field-text">静岡県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-23"> <input type="radio" name="prefectures" value="愛知県" id="prefectures-23" class="required" /> <span class="mwform-radio-field-text">愛知県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-24"> <input type="radio" name="prefectures" value="三重県" id="prefectures-24" class="required" /> <span class="mwform-radio-field-text">三重県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-25"> <input type="radio" name="prefectures" value="滋賀県" id="prefectures-25" class="required" /> <span class="mwform-radio-field-text">滋賀県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-26"> <input type="radio" name="prefectures" value="京都府" id="prefectures-26" class="required" /> <span class="mwform-radio-field-text">京都府</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-27"> <input type="radio" name="prefectures" value="大阪府" id="prefectures-27" class="required" /> <span class="mwform-radio-field-text">大阪府</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-28"> <input type="radio" name="prefectures" value="兵庫県" id="prefectures-28" class="required" /> <span class="mwform-radio-field-text">兵庫県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-29"> <input type="radio" name="prefectures" value="奈良県" id="prefectures-29" class="required" /> <span class="mwform-radio-field-text">奈良県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-30"> <input type="radio" name="prefectures" value="和歌山県" id="prefectures-30" class="required" /> <span class="mwform-radio-field-text">和歌山県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-31"> <input type="radio" name="prefectures" value="鳥取県" id="prefectures-31" class="required" /> <span class="mwform-radio-field-text">鳥取県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-32"> <input type="radio" name="prefectures" value="島根県" id="prefectures-32" class="required" /> <span class="mwform-radio-field-text">島根県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-33"> <input type="radio" name="prefectures" value="岡山県" id="prefectures-33" class="required" /> <span class="mwform-radio-field-text">岡山県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-34"> <input type="radio" name="prefectures" value="広島県" id="prefectures-34" class="required" /> <span class="mwform-radio-field-text">広島県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-35"> <input type="radio" name="prefectures" value="山口県" id="prefectures-35" class="required" /> <span class="mwform-radio-field-text">山口県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-36"> <input type="radio" name="prefectures" value="徳島県" id="prefectures-36" class="required" /> <span class="mwform-radio-field-text">徳島県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-37"> <input type="radio" name="prefectures" value="香川県" id="prefectures-37" class="required" /> <span class="mwform-radio-field-text">香川県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-38"> <input type="radio" name="prefectures" value="愛媛県" id="prefectures-38" class="required" /> <span class="mwform-radio-field-text">愛媛県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-39"> <input type="radio" name="prefectures" value="高知県" id="prefectures-39" class="required" /> <span class="mwform-radio-field-text">高知県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-40"> <input type="radio" name="prefectures" value="福岡県" id="prefectures-40" class="required" /> <span class="mwform-radio-field-text">福岡県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-41"> <input type="radio" name="prefectures" value="佐賀県" id="prefectures-41" class="required" /> <span class="mwform-radio-field-text">佐賀県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-42"> <input type="radio" name="prefectures" value="長崎県" id="prefectures-42" class="required" /> <span class="mwform-radio-field-text">長崎県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-43"> <input type="radio" name="prefectures" value="熊本県" id="prefectures-43" class="required" /> <span class="mwform-radio-field-text">熊本県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-44"> <input type="radio" name="prefectures" value="大分県" id="prefectures-44" class="required" /> <span class="mwform-radio-field-text">大分県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-45"> <input type="radio" name="prefectures" value="宮崎県" id="prefectures-45" class="required" /> <span class="mwform-radio-field-text">宮崎県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-46"> <input type="radio" name="prefectures" value="鹿児島県" id="prefectures-46" class="required" /> <span class="mwform-radio-field-text">鹿児島県</span> </label> </span> <span class="mwform-radio-field horizontal-item"> <label for="prefectures-47"> <input type="radio" name="prefectures" value="沖縄県" id="prefectures-47" class="required" /> <span class="mwform-radio-field-text">沖縄県</span> </label> </span> <input type="hidden" name="__children[prefectures][]" value="{"\u5317\u6d77\u9053":"\u5317\u6d77\u9053","\u9752\u68ee\u770c":"\u9752\u68ee\u770c","\u5ca9\u624b\u770c":"\u5ca9\u624b\u770c","\u5bae\u57ce\u770c":"\u5bae\u57ce\u770c","\u79cb\u7530\u770c":"\u79cb\u7530\u770c","\u5c71\u5f62\u770c":"\u5c71\u5f62\u770c","\u798f\u5cf6\u770c":"\u798f\u5cf6\u770c","\u8328\u57ce\u770c":"\u8328\u57ce\u770c","\u6803\u6728\u770c":"\u6803\u6728\u770c","\u7fa4\u99ac\u770c":"\u7fa4\u99ac\u770c","\u57fc\u7389\u770c":"\u57fc\u7389\u770c","\u5343\u8449\u770c":"\u5343\u8449\u770c","\u6771\u4eac\u90fd":"\u6771\u4eac\u90fd","\u795e\u5948\u5ddd\u770c":"\u795e\u5948\u5ddd\u770c","\u65b0\u6f5f\u770c":"\u65b0\u6f5f\u770c","\u5bcc\u5c71\u770c":"\u5bcc\u5c71\u770c","\u77f3\u5ddd\u770c":"\u77f3\u5ddd\u770c","\u798f\u4e95\u770c":"\u798f\u4e95\u770c","\u5c71\u68a8\u770c":"\u5c71\u68a8\u770c","\u9577\u91ce\u770c":"\u9577\u91ce\u770c","\u5c90\u961c\u770c":"\u5c90\u961c\u770c","\u9759\u5ca1\u770c":"\u9759\u5ca1\u770c","\u611b\u77e5\u770c":"\u611b\u77e5\u770c","\u4e09\u91cd\u770c":"\u4e09\u91cd\u770c","\u6ecb\u8cc0\u770c":"\u6ecb\u8cc0\u770c","\u4eac\u90fd\u5e9c":"\u4eac\u90fd\u5e9c","\u5927\u962a\u5e9c":"\u5927\u962a\u5e9c","\u5175\u5eab\u770c":"\u5175\u5eab\u770c","\u5948\u826f\u770c":"\u5948\u826f\u770c","\u548c\u6b4c\u5c71\u770c":"\u548c\u6b4c\u5c71\u770c","\u9ce5\u53d6\u770c":"\u9ce5\u53d6\u770c","\u5cf6\u6839\u770c":"\u5cf6\u6839\u770c","\u5ca1\u5c71\u770c":"\u5ca1\u5c71\u770c","\u5e83\u5cf6\u770c":"\u5e83\u5cf6\u770c","\u5c71\u53e3\u770c":"\u5c71\u53e3\u770c","\u5fb3\u5cf6\u770c":"\u5fb3\u5cf6\u770c","\u9999\u5ddd\u770c":"\u9999\u5ddd\u770c","\u611b\u5a9b\u770c":"\u611b\u5a9b\u770c","\u9ad8\u77e5\u770c":"\u9ad8\u77e5\u770c","\u798f\u5ca1\u770c":"\u798f\u5ca1\u770c","\u4f50\u8cc0\u770c":"\u4f50\u8cc0\u770c","\u9577\u5d0e\u770c":"\u9577\u5d0e\u770c","\u718a\u672c\u770c":"\u718a\u672c\u770c","\u5927\u5206\u770c":"\u5927\u5206\u770c","\u5bae\u5d0e\u770c":"\u5bae\u5d0e\u770c","\u9e7f\u5150\u5cf6\u770c":"\u9e7f\u5150\u5cf6\u770c","\u6c96\u7e04\u770c":"\u6c96\u7e04\u770c"}" /> </div> </div> </div> </dd> </dl> </li> <li> <dl> <dt> 都道府県以下市町村 </dt> <dd> <input type="text" name="municipality" size="60" value="" placeholder="千代田区丸の内2-5-2 三菱ビル" /> </dd> </dl> </li> <li> <dl> <dt>電話番号</dt> <dd> <input type="text" name="tel" id="tel" size="60" value="" placeholder="0312345678" /> </dd> </dl> </li> <li> <dl> <dt class="label-required"> メールアドレス <span>※必須</span> </dt> <dd> <input type="email" name="emailaddr" class="required" size="60" value="" placeholder="you@example.com" data-conv-half-alphanumeric="true"/> </dd> </dl> </li> <li> <dl> <dt class="label-required"> お問い合わせ内容 <span>※必須</span> </dt> <dd> <textarea name="message" class="required" cols="50" rows="5" placeholder="自由にお書きください"></textarea> </dd> </dl> </li> <li> <dl> <dt class="label-recaptcha"><span>reCAPTCHA</span></dt> <dd> <div class="g-recaptcha inquiry-recaptcha" data-sitekey="6Leyfv0mAAAAAHmTqPaHeAhGbhGpet_4lfvPrgtt" data-callback="acmgc_captcha_check" 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