Musashi Gakki Piano Purchase Assessment Application Form

    Piano Information

    * Piano Manufacturer

    If you selected 'Other', please enter the manufacturer's name.

    * Piano Color

    If you selected 'Other', please enter the color.

    * Type of Piano

    Piano Model Name (Model Number)

    Piano Serial Number

    The model number and serial number can be found inside the lid of the piano. If you are unable to check it, please contact us at 0120-634-860.
    * Number of Pedals

    * オプション

    * Condition of the Piano

    * Year of Purchase

    Location information of the piano.

    * Location of the piano.

    * Floor number of the installation location.

    * Presence of elevator

    * Previous delivery method.

    * The number of steps from the road to the entrance

    If you have any comments or questions, please write them down.

    Customer Information

    * Last Name

    * First Name

    * Last Name (Furigana)

    * First Name (Furigana)

    * Postal Code


    * Prefecture


    * City


    * Street Address


    Building Name / Room Number


    * Email Address


    * Confirm Email Address


    * Phone number (without hyphens).


    Please write any other questions or inquiries.


    * Preferred method of contact


    If you don't mind, please kindly participate in our survey.


    Reason for letting go of the piano.



    If you selected "Other," please let us know the reason.


    Environment where the piano is placed



    How did you hear about Musashi Instruments?