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Free PE Application Form

Thanks for participating in our Free PE promotional offer!


During the month of February 2010, we are waiving the $40.00 fee for reviewing scores from any of 200 standardized intelligence tests for Mensa membership. By providing your information below, you will be directed to our Free PE application that you must return during the month of February to waive the $40.00 fee.

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*First Name:

*Last Name:

*Address 1:

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*City:

*State:

*Zip + 4: -

Phone:
(Please include area code)

Email Address:

Birth Date: (Optional) Month:    Day:    Year:



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