Testing calendar information form

Thank you for your interest in our calendar of upcoming test dates!  In order to provide better information about testing locations near you, we ask that you provide your information below.  In addition to unlimited calendar access for the next 90 days, you'll also receive an email with more information on testing and contact information for a volunteer testing coordinator in your area.

If you're a current Mensa member, please log in to our Web site for access to the testing calendar.

 

Please complete the form below. By providing your information, you will receive a contact for a volunteer who coordinates testing in your area.

* Indicates required fields
 
*First Name:
*Last Name:
*Address 1:
Address 2:
*City:
*State:
*Zip + 4: -
Phone:
*Email Address:
Birth Date: (Optional) Month:    Day:    Year:
Thank you for visiting our Web site. How did you hear about us?
If we can accommodate you, are you interested in testing for membership in: