Intellectual Benefits to Society Award nomination

This award program recognizes the application of Mensans' intellectual abilities that result in tangible benefit to society (excluding political activities). These applications of ability may be paid or unpaid; consideration is given to the number of individuals impacted. Self-nomination is encouraged!

Nominee Information (Mensa membership required)


Mensa Membership ID:
First Name:
Last Name:
Address:
City:
State:
Zip code:
Email Address:
Phone Number:
Nominated By: Self Other
 
 

Nominator Information (Mensa membership not required)


Mensa Membership ID:
First Name:
Last Name:
Address:
City:
State:
Zip code:
Email Address:
Phone:
 
 

Accomplishment Information


Subject of the Accomplishment:

In 300 words or fewer, describe the problem, difficulty, or other circumstances that is addressed by the creative achievement. Include how long the problem has persisted, if known.

 
Description of the Accomplishment:

Describe the achievement, including the estimated number of people impacted. Please limit your answer to 500 words or fewer.

 
 

File Attachments (allowed types include .pdf, .doc, .wpd, .rtf, .txt)

Please include clippings from periodicals, professional journal articles, or other documents that provide objective evidence of the problem, implementation, recognition, significance, etc., may be attached to support the nomination.

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