CP Mensa Solstice RG 2018 Registration Form
Email address *
Full name *
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Name for badge *
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Local Mensa Group
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Mensa Title (if you have one)
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Additional people included in this registration (Please give full name and name on badge)
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Full Mailing Address *
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Phone number
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Amount paid (Please send payment through PayPal to shoikana@gmail.com or send a check made out to Central Penn Mensa to Joy Lederman (her address is on the Solstice website page)). *
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A copy of your responses will be emailed to the address you provided.
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