[SHIMADZU] Inquiry for SHIMADZU ID Service

<!DOCTYPE html> <html> <head>  <script>(function(w,d,s,l,i){ w[l]=w[l]||[]; w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'}); var f=d.getElementsByTagName(s)[0]; var j=d.createElement(s); var dl=l!='dataLayer'?'&l='+l:''; j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl+''; j.async=true; f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer','GTM-P7QKMX3');</script>  <meta name="tracking_form_type" content="g-id_contact"/> <meta name="tracking_form_status" content="input"/> <meta charset="utf-8"> <meta http-equiv="X-UA-Compatible" content="IE=edge"> <meta http-equiv="Content-Type" content="text/html; charset=utf-8" /> <title>[SHIMADZU] Inquiry for SHIMADZU ID Service</title> <meta name="keywords" Content=""> <meta name="description" Content=""> <style type="text/css" media="all"> @import url("/form/g-common_rw/css/style.css"); @import url("/form/g-common_rw/css/form.css"); </style> <script> var ua = navigator.userAgent; if (ua.indexOf('iPad') > 0 || (ua.indexOf('Android') > 0 && ua.indexOf('Mobile') < 0)) { document.write('<meta name="viewport" content="width=1040">'); } else { document.write('<meta name="viewport" content="width=device-width,initial-scale=1">'); } </script> <SCRIPT language="JavaScript"> function chg_gd(){ var rand = Math.floor( Math.random() * 100000); var gdtag = "<img src=\"/cgi-bin/gd.cgi?aaa=" + rand + "\" style=\"width:200px;height:50px\">"; document.getElementById("gdimg").innerHTML = gdtag; } </SCRIPT> </head> <body>  <noscript aria-hidden="true"><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-P7QKMX3" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>  <div id="wrapper"> <header>   <section id="head"> <div class="container"> <p id="logo"><a href="https://www.shimadzu.com/">SHIMADZU</a></p> </div> </section>   <nav id="gnav" class="hidden-pc"><div class="container"><ul class="global"><li><a href="https://www.shimadzu.com/"><span>HOME</span></a></li></ul></div></nav>   </header> <div id="main"> <div class="container">  <section class="pageTitle"> <h1 class="heading-01">Inquiry for SHIMADZU ID Service</h1> </section>  <ul class="note"> <p>Use this form for inquiries about the SHIMADZU ID Service.<br> Submit other inquiries from <a href="https://www.shimadzu.com/contact/index.html" target="_blank">here</a>.</p> <p class="form-item-button-wrapper"> <a href="https://www.shimadzu.com/an/service-support/contact/index.html" class="btn-primary padding-right-30 padding-left-30">Analytical Product Inquiry</a> </p> <br> <p class="form-item-button-wrapper"> <a href="/form/id/jp/contact.html" class="btn-primary padding-center-30 padding-left-30">Inquiries in Japanese about the SHIMADZU ID service</a> </p> <p>* Submit an inquiry in English or Japanese.<br> * Your inquiry will automatically be sent back to your e-mail address. Please keep it as a record of your submission.<br> * Your personal information entered in the following form may be used by us to contact you about your inquiry.<br> * Please note that we will respond to your inquiry only on Shimadzu Corporation’s business days.</p> </ul>  <h2 class="form_subttl01">Contact Information</h2> <form action=/cgi-bin/MailDeliver.cgi method="post"> <input name="CFGFILE" type="hidden" value="g-id_contact"> <div class="form-area"> <p class="must">All fields marked with<span class="red">*</span> are required</p> <table class="form_box01"> <tr> <th>Type of inquiry<span class="red">＊</span></th> <td> <div class="selectWrap"> <select name="type" class="kenmei"> <option value=""></option> <option value="About SHIMADZU ID Service">About SHIMADZU ID Service</option> <option value="Cannot register for SHIMADZU ID Service">Cannot register for SHIMADZU ID Service</option> <option value="Cannot log in to SHIMADZU ID Service">Cannot log in to SHIMADZU ID Service</option> </select> </div><br> For other inquiries such as product, please input from <a href="https://www.shimadzu.com/contact/index.html">here</a>. </td> </tr> <tr> <th>Name<span class="red">＊</span></th> <td><input class="middle" type="text" name="name"> </td> </tr> <tr> <th>Organization<span class="red">＊</span></th> <td><input class="middle" type="text" name="org" > </td> </tr> <tr> <th>Country<span class="red">＊</span></th> <td><input class="middle" type="text" name="country" > </td> </tr> <tr> <th>E-mail<span class="red">＊</span></th> <td><input type="text" name="email" id="email" class="middle"> </td> </tr> <tr> <th>Comments/Requests<span class="red">＊</span></th> <td><textarea cols="50" rows="5" name="textarea" class="sp-w100"></textarea></td> </tr> <tr> <th>Verification Code<span class="red">＊</span></th> <td> <div style="white-space: nowrap;margin-bottom:10px"> <span id="gdimg" style="width:200px;"><img src="/cgi-bin/gd.cgi" width="200"></span> <input type="button" value="Get a new code" onclick="chg_gd();" style="vertical-align: top;" > </div> <input type="text" name="recaptcha-response" value="" class="txt_width blue" > </td> </tr> </table> <div style="text-align:center;margin-top:10px;margin-bottom:10px;font-size:14px"> <label><input type="checkbox" name="policy_agree" style="width:20px !important" value="policy_agree" ><span style="color:red">*</span>I AGREE TO THE SHIMADZU PRIVACY POLICY AND TERMS OF USE</label><br > Read Shimadzu <a href="https://www.shimadzu.com/privacy/index.html" target="_blank">Privacy Policy</a> and <a href="https://www.shimadzu.com/terms/index.html" target="_blank">Terms of Use</a> </div> <div id="form_button"> <ul> <li class="submit"> <button type="submit" value="CHECK" name="CHECK">SUBMIT</button> </li> <li class="reset"><a href="/form/id/contact.html">RESET</a></li> </ul> </div>  </div>  </form>  </div>   <footer> <div class="container"> <ul class="links hidden-sp"> <li><a href="https://www.shimadzu.com/privacy/index.html" target="_blank">PRIVACY POLICY</a></li> <li><a href="https://www.shimadzu.com/terms/index.html" target="_blank">TERMS OF USE</a></li> <li><a href="https://www.shimadzu.com/sitemap/index.html" target="_blank">SITE MAP</a></li> </ul> <p class="copyright"><img src="/form/g-common_rw/images/copyright.png" alt="Copyright Shimadzu Corporation. 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[SHIMADZU] Inquiry for SHIMADZU ID Service