Due two weeks before your Regional Student Conference (RSC)
(Contact your Regional Office for the date)
FROM (school): _______________________________________________
PROTOTYPE NAME: _______________________________________________
TEAM MEMBER INFORMATION:
NAME: ________________________________________________
ASME MEMBER #: ________________________________________________
SS#: ________________________________________________
NAME: ________________________________________________
ASME MEMBER #: ________________________________________________
SS#: ________________________________________________
NAME: ________________________________________________
ASME MEMBER #: ________________________________________________
SS#: ________________________________________________
NAME: ________________________________________________
ASME MEMBER #: ________________________________________________
SS#: ________________________________________________
I/We are planning to enter a device in the competition to be held at the
RSC.
I/We can be contacted at:
NAME: _______________________________________________
PERMANENT MAILING ADDRESS:
_______________________________________________
_______________________________________________
_______________________________________________
TELEPHONE NO: _________________________
FAX NO: ________________________
E-MAIL ADDRESS: __________________________________________________________
Mail, FAX, or e-mail information to your ASME
Regional
Office.