~~~ Los Angeles Area Mensa ~~~ San Fernando Valley Mensa Exam Registration Form ~~~ (updated 07-27-10)
Douglas Aberg, Mensa Proctor, 661-916-3015 (No calls after 8 PM please) Mail to: dougaberg-at-gmail.com
Please fill it out as accurately as possible, then press the SEND BUTTON to email the information to me. (This information should be the same as where you'd like your test results sent.) I will send you a confirmation that you've registered for the upcoming Mensa exam.
LOCATION: Hampton Inn, 5638 Sepulveda Boulevard, Sherman Oaks, CA 91411, (818) 785-2211 One short block North of Burbank Blvd. Free parking behind the hotel.
If you need the Culture-Free exam, given several times a year in Pasadena, please REQUEST that in the Comments section, with the proper Date and Time. Otherwise we assume you are registering for the standard English-based exam.. Also note that those under the age of 18 are required to have a parent or legal guardian, with photo ID, with them. Students should have their school or other photo ID.
If you do not hear from me within a few days, please send me a separate email not using this form. Thanks!
PLEASE do not press the ENTER or SEND key until finished - use the TAB key or the mouse cursor to move from field to field, and when finished, press the SEND BUTTON to send this information to us. Thanks!