Mensa Foundation Prize - Nomination

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Mensa Foundation Prize

Mensa Foundation Prize Nomination

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Nominee Information

Please provide information here on the individual you are nominating.

Organization

First Name*

Last Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email Address*

Phone Number*

Nominated by:

Self Nomination

Someone Else

Nominator Information

Please also provide your information here as the nominator.

Organization

First Name*

Last Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email Address*

Phone Number*

Submission Information

Summary of Nominee’s Scientific Discovery*

Describe the scientific discovery in the field of intelligence or creativity in 500 words or fewer.

Nominee's Curriculum Vitae (PDF files only)*

Max. file size: 50 MB.

Nominee's Meritorious Bibliography (PDF files only)*

Max. file size: 50 MB.

Two Letters of Support (PDF files only)*

Drop files here or

Max. file size: 50 MB.

I have read and understand the rules and conditions set out above and this nominee meets all of them to the best of my knowledge. I agree to accept the judges' decisions as final. I understand that any award may be revoked, in the Mensa Foundation's sole discretion, if the nominee fails to embody the values, mission, and vision of the Mensa Foundation and/or commits acts that negatively affect the reputation and goodwill of the Mensa Foundation and/or American Mensa.*

I accept

Nomination