MEMBERSHIP APPLICATION

Please complete in BLOCK CAPITALS and return to the
Scotch Malt Whisky Society, Postbus 1812, 4700 BV
Roosendaal, The Netherlands.

NAME:______________________________________________________

ADDRESS:___________________________________________________

POSTCODE:__________________________________________________

TOWN_______________________________________________________

COUNTRY____________________________________________________

DAYTIME PHONE:_____________________________________________

EVENING PHONE:_____________________________________________

FAX:_______________________________________________________

SIGNATURE:_________________________________________________

An increasing number of Society documents are available in German.
When a choice is available, please indicate which language you prefer:

            English         German

The initial subscription covers your first year's membership and an
excellent introductory bottle of Society whisky. Membership costs
NLG 160, BEF 3030 or DEM 142. Please select one of the following
payment methods:

__ Bank transfer for Germany ABN/AMRO Düsseldorf
   No 14.32.664/018. Bankleitzahl 301 204 00 (DEM)
__ Bank transfer for The Netherlands ABN/AMRO
   No 46.25.27.700 (NLG)
__ Bank transfer for Belgium BBL No 310.1190885.05 (BEF)
__ A guaranteed, completely filled-in and crossed Eurocheque
   in Dutch Guilders (please do not forget your pass-number!)
__ Giro betaalkaart
__ Diners Club   __ American Express   __ Visa   __ Euro/Mastercard

     __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
  
     Good thru ___/___


Please allow 14 days for delivery. Do not accept damaged goods;
instruct postman to return package to The Society. A replacement
will be despatched immediately.

Membership is renewable annually on the anniversary of your enrolment,
and the annual subscription costs NLG 60, BEF 1135 or DEM 54.

The Society reserves the right to refuse or terminate membership.

           The Scotch Malt Whisky Society
                 Vijfhuizenbert 103
                    Postbus 1812
                 4700 BV Roosendaal
                  The Netherlands

                Tel +31-165-533-134
                Fax +31-165-540-067
                E-mail smws@epost.nl