Miki House Pregnancy / Childbirth / Child Care Support Inquiry Form

Thank you for your interest in "Miki House pregnancy, childbirth, child -rearing support".
Please fill in the necessary information, such as the contents of the inquiry below, and send it.
The person in charge will contact you within 24 hours.
* In the case of weekends and holidays, we will contact you after the next business day.

To receive the application completion email

mhbmp@mail.mikihouse.co.jpReception setting
Enter the correct email address
Check the capacity of the mail server (you will not be able to receive it if it is full)

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In addition, the automatic response email may be blocked with your security software, so we hope you can check it together.

Please choose the contents that are interested.Essential

Miki House About pregnancy / childbirth / child care support

About holding the pre -mama and premama seminar

Initiatives with maternity / postpartum care facilities

others Example) Consultation on projects and specific projects that the person in charge is already implementing.

Please let us know what you want. Essential

I want to meet and listen to the story

I want to hear the story on the phone / I want a phone

I want to hear the story online such as ZOOM

others

Please enter the information of the person in charge.

Municipalities, companies, group names, and affiliated departmentsEssential

* Please enter the name of the affiliated department.
* If you are a personal customer, please enter that.

Please enter

nameEssential

Surname

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given name

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name)Essential

Surname

Please enter in the full-width katakana

Good

Please enter in the full-width katakana

contact address

telephone numberEssential

* Please fill in with hyphen and half -width numbers. * If you do not receive the application completion email, we will call.

Please enter

E-Mail addressEssential

Please enter a valid email address

Please enter again for confirmation

We will send you the application completion email notification and details to your email address. Please register the address that can be received reliably. * Please be able to receive emails from "@mikihouse.co.jp".

The email address does not match

* Enter the correct email address,mhbmp@mail.mikihouse.co.jpPlease set the email reception.

Address

post codeEssential

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prefecturesEssential

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municipalitiesEssential

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Street BunchEssential

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Building name, room numberAny

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Content of inquiryEssential

Please enter

* Please check the entered email address again.
※mhbmp@mail.mikihouse.co.jpPlease set the reception.