2018 ASC Region 4 Student Competition Registration Form
Important Dates:
*** Entry Form (below) must be submitted by SEPTEMBER 25.
*** Registration Fee ($400 per team) is due OCTOBER 1.

If you have any questions, please contact the ASC Region 4 Director - Dr. Richard Gebken at 417.836.5270.

School Name: *
Your answer
School Address (1): *
Your answer
School Address (2): *
Your answer
City: *
Your answer
State: *
Your answer
Zip Code: *
Your answer
Division: *
Team Member (1): *
Your answer
Team Member (2): *
Your answer
Team Member (3): *
Your answer
Team Member (4): *
Your answer
Team Member (5): *
Your answer
Team Member (6):
Your answer
Faculty Coach: *
Your answer
Faculty Email: *
Your answer
Faculty Phone: *
Your answer
Payment: *
Additional Comments:
Your answer
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