THE HASH HOUSE PARTNERSHIP APPLICATION FORM
Applicant's Details
HASH CHAPTER *
TOWN / AREA
HASH Name of Person Applying
Mailing Address *
CITY *
POSTCODE *
COUNTRY *
email *
Mobile Phone Nr *
Fax
Name of Person Pledging on behalf of Chapter
Position Held in Chapter
email contact of Pledger
PARTNERSHIP TYPE / LEVEL
I hereby acknowledge that I am authorized by my Hash Chapter to make this pledge on their behalf *
  Torch Bennet Partner (Donation RM6000 or USD2,000 or more)  
  Horse Thomson Partner (Donation RM16000 or USD5,000 or more)  
  Cecil Lee Partner (Donation RM32000 or USD10,000 or more) 
  “G” Gispert Partner (Donation RM63000 or USD20,000 or more) 
*All Hash House Partners will be permanently and appropriately acknowledged in The Hash House, according to the amount raised

Please indicate your choice of Partnership Level
Subscription, if any, will not be levied until The Hash House is commissioned.
Bank Draft Nr
or Cheque Nr (Malaysian Drawee Bank Only)
Total Drawn On Amount (RM or USD XX XXX.XX
Indicate your form of Payment here
PAYMENT DETAILS
Payment must be made payable to "YHH-THE HASH HOUSE BUILDING FUNDS".

For Electronic Transfer
- Beneficiary Account Name: YHH-THE HASH HOUSE BUILDING FUNDS
- Beneficiary Account No: 101-078889-101
- Beneficiary Bank Name: HSBC BANK MALAYSIA BERHAD
- Swift Code: HBMBMYKL

Alternatively, you may also send your completed printed form to ;
THE HASH HOUSE MEMBERSHIP OFFICE
1007, 10TH FLOOR BLOCK A, DAMANSARA INTAN
1, JALAN SS 20/27, 47400 PETALING JAYA, SELANGOR, MALAYSIA
EMAIL: hashchapters@thehashhouse.org
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Please include a photo of Chapter and logo along with this application
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