Request for booking Tokyo-Narita international airport care taxi alliance : T-Nacts

Fill out the entry form and click the "Next" please.

Firm_name_of_applicant
Applicant_name *Required.
Applicant_telephone
E-Mail *Required.
Name_of_Wheelchair_user
Equipment_selection *Required.
Weight_of_your_electric_wheelchair kg :Electric wheelchair user only
Overall_maximum_width_of_your_wheelchair cm
PLS refer to this picture. This case, overall maximaum width is 69cm.(between handrims)
Overall_height_above_floor_including_wheelchair_user cm
PLS refer to this picture. This case, overall maximaum width is 129cm.
Total_number_of_the_passenger_on_board_(including_wheelchair_user) person *Required.
Baggage_size_and_quantity
Contact_address_(cell_phone)_at_Narita_airport
One_way/Round_trip One way  Round trip *Required.
Arriival_date_(Japan_time)_at_Narita_airport :within a month. *Required.
Airline_company *Required.
Flight_number *Required.
Arrival_time
Terminal_number_of_Narita_airport
Departure_date_(Japan_time)_at_Narita_airport :Round trip customer only
Flight_number_of_return_flight :Round trip customer only
Departure_time_of_return_flight :Round trip customer only
Destination_(Hotel_name_or_etc)
*Required.
Note

 

Thank you for your cooperation !