Student Application for ASM International Orange Coast Chapter 2019 Materials Camp
Items followed by a red asterisk (*) must be completed properly before proceeding to the next section. All 5 sections must be completed properly for you to be considered for camp.
Students MUST provide proof of medical insurance that is active during camp. Contact us at if you have questions or need help obtaining short-term medical insurance for camp. Use "Camp Medical Insurance" as the subject line.
Some factory tours require proof of U.S. citizenship to visit certain areas containing U.S. government classified activities. Non-citizens may be allowed to tour unclassified areas of those factories.
First Name *
Last Name *
Personal (NOT SCHOOL) Email Address *
Home Address *
Address Line 2 (if needed)
City *
State *
Zip Code *
Phone number *
Do you want to save your partly-completed application, and quit for now? If so, answer "Yes" and you may finish at a later time by returning to your application, using the same Google account. To submit your application, you must complete ALL 5 sections below by the due date. Answer "No" if you want to continue now to the next section. *
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