APPLICATION

I would like to join the Scotch Malt Whisky Society. 
The annual membership fee is Fr. 40.

LAST NAME:______________________________________

FIRST NAME:_____________________________________

SEX:     Male     Female     Couple

ADDRESS:________________________________________

________________________________________________

________________________________________________

HOME PHONE:_____________________________________

OFFICE PHONE:___________________________________

FAX:____________________________________________

I prefer Society documents in:

        English     German     French
        
If you chose French as your preferred language, 
please indicate whether we can correspond with you 
(letters and phone calls) in another language.

      English     German     French only

I heard about the Society from:


Certification: I am at least 18 years of age.

PLACE:__________________________________________

DATE:___________________________________________

SIGNATURE:______________________________________


          The Scotch Malt Whisky Society
                  Haumuehle 231
                   8424 Embrach
                   Switzerland
                   
                Tel +41-1-866 20 50
                Fax +41-1-866 20 51