~~~ Los Angeles Area Mensa ~~~ West Los Angeles Mensa Exam Registration Form ~~~ (updated 07-27-10)

Raulette Woods, 310-751-6309 (Messages: No calls after 8 PM please) Contact: Raulette.Mensa-at-yahoo.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.) If you need testing in a different area, please place that information in the Location section. I will send you a confirmation that you've registered for the upcoming Mensa 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.

LOCATION: Doubletree Hotel LAX, 1985 East Grand Avenue, El Segundo, CA 90245-5015 (310) 322-0999 Free parking in lot or in Mattel Parking tower

DIRECTIONS:  One block East of Sepulveda Bl, one large block North of El Segundo Blvd, a few blocks South of LAX Airport.

If you do not hear from me within a few days, please send me a separate email not using this form. Thanks! This form does not tell us, unless you fill it in, what testing session you wanted, so please be exact in the date and time information desired.