12th Pan Asia Hash 2009 Registration Form
Name*
*Last Name
*First Name
Mailing Address*


*Street No. / City / State / Province


*Country
Fax
Email
Nationality
Gender

Birth Date
DD MM YYYY
Run Length
T-shirt Size
Hash Name
Home Hash
Passport #

Emergency Contact Information

 

*Name

*Emergency Contact Number

Account Details:

Hash 2009 Events Management

Bank of the Philippine Islands (BPI)

Branch - Boni Ave. Mandaluyong, Philippines Account No. 3854-0125-75

(All bank charges must be covered by the remitter)