キャンペーン賞品受取りフォーム

This form is a contact for 14 days posts prize,Starbucks eGift.
Time limit: 07:00 Monday 17th of May 2021 [Japan Time]
Please input from No.1 to No.4 and push [Submit] bottun.

1. Name *

Sample: Kaji

2. E-mail *

Sample: thisismyname@gmail.com

3. Contact you get the prize *

Please choose one.
---E-mailLINE chatInstagram Direct Message

4. Two good points and two bad points of Kaji Blog with each reason *

5. Free message

Sample: Actually I posted on my blog.Please give me the prize! Thank you.

When you push [Submit],the data will be sent immediately. Please check them.