SIGs Recognition Form

Fill out the following form and either email or snail-mail it to the SIGs Officer, Andrew York. Contact information for him can be found in the Officer Listing.

Name of SIG:

Name of Coordinator:

Address:

City/State/ZIP:

Telephone number(s)
Home:
Work:

Mensa Membership number:

Do you wish SIG Information to be listed on the internet?:

Would your SIG be actively seeking members in other countries?:

Please describe the subject matter, financing arrangements and planned activities fo your SIG in substantial detail. Take as much space as you need. If you have a co-coordinator or editor, please provide that individual's name, address, telephone number and Mensa membership number.

If you intend to produce a newsletter, write its title:
You need not furnish your newsletter name at this time, but prior to publication, its title MUST be approved by the SIGs Officer to avoid duplication.

Your directory can include 200 characters AFTER your name, address and ZIP code (which must match the information on file in the national office). Please check the format other SIGs have used in the directory (in the March and Sept Mensa Bulletins), then write your listing in the spaces below.

Please don't use ALL the character spaces unless you really need them.

__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __
__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

Return to the main SIGs page