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2009 ASM Materials Camp New England Application Form
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       Copy the Teacher Recommendation Form (optional) below (right click then "Save Target or  Link as . . ") and forward by email to your Teacher, then complete ALL the fields below and hit the Submit button.  You will receive a confirmation by email that your application has been received.  If you do not receive confirmation within a week, please contact Gary Haupt at the address below.

Applications must be received by April 10th, 2009
For more information, contact Gary Haupt at (508) 809-5132 haupt.gary@yahoo.com or Joseph Oparowski at (508) 766-1371 joseph_oparowski@bose.com
Teachers' recommendation form (optional): 2009 ASMMCNE Teacher Recommendation Form
Student Name:              
Student Address: Street: City:                       State:    Zip Code:
  Home Phone: email:        
Sex (M/F):              
Date of Birth (mm/dd/yy):            
Current Grade:            
School Name:  
School Address: Street: City:                      State:    Zip Code:
  Phone:            
Principals' Name:              
Teachers' Name:              
                 
Do you plan to attend college? (Y/N): Yes  No        
Have you participated in a science fair? (Y/N): Yes  No
Are you a member of an academic group or club? (Y/N): Yes  No Club or group name:  
Will a teacher accompany you to the camp? (Y/N): Yes  No        
     if yes, Teachers' Name:            
  Teachers' Phone:            
  Teachers' email:            
                 

Tell us why you would like to attend Materials Camp:

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