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:
Postal 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:
Postal Code:
*Email Address:
*Phone:
 
 
Accomplishment Information

Subject of the Accomplishment:
(In 300 words or less, 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. Please do not exceed one page for this section. 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.)
 
 
File Attachments (allowed types include .pdf, .doc, .wpd, .rtf, .txt)
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