Shoei X-Eleven Order Form ( SHIP IN JAPAN ONLY )

ProductShoei X-Eleven Model: Choose the model Norick Abe TC1 *code/X110051 Norick Abe TC2 *code/X110052 Daijiro TC1 (red) *code/X110071 Daijiro TC3 (yellow) *code/X110073 Vermeulen2 TC2 (blue) *code/X110162 Vermeulen2 TC3 (yellow) *code/X110163 Kagayama TC1 (red/white) *code/X110061 Kagayama TC2 (blue/white) *code/X110062 Kagayama TC5 (silver/white) *code/X110065 Yanagawa TC4 (green) *code/X110154 Kiyonari TC1 (red/black) *code/X110081 Kiyonari TC2 (blue/black) *code/X110082 Kiyonari TC5 (black) *code/X110085 Ito TC1 (red) *code/X110171 Ito TC2 (blue) *code/X110172 Tamada TC5 (black/silver)*code/x110185 Tamada TC6 (white/silver)*code/x110186 Elias TC1 (red/black)*code/X110191 Elias TC3 (yellow/black)*code/X110193 Size: S (55-56cm) M (57-58cm) L (59-60cm) XL (61-62cm) Quantity: 1 2 Optional shield Non CX1V Mirror silver ( soft smoke ): 8,190JPY CX1V Mirror Gold ( smoke ): 8,190JPY CX1V Mirror Blue ( smoke ): 8,190JPY CX1V Dark smoke: 3,990JPY CX1V Smoke: 3,990JPY CX1V light smoke (standard equipment): 3,990JPY CX1V Clear: 3,990JPY Optional Shield quantity 0 1 2 3 Payment Method: Paypal (Credit card or Bank) Bank transfer Your e-mail: First Name: Last Name: Your Address: Your phone number Shipping address ( In Japan only) : Shipping Phone Number: Other Comments:

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We ship the helmets in Japan only.

Please do not write your credit card number in this order form.
We will send the paypal invoice to your mail address when we have the stock.
Please pay the amount through the paypal service using your credit card or bank.