PO Box 7178, Helena, MT 59604-7178
DNA TESTING APPLICATION

Please complete this application form and return it with appropriate documentation. The form may be submitted on-line, if desired; otherwise, after completion, print it and mail. Please be certain to provide a pedigree or lineage chart so we may see how your family fits into the entire testing scheme.

First Name
Middle Name
Last Name
Email
Street address
City
State or Province
Country
Postal code
Date
Telephone

Please communicate with the testing coordinator prior to selecting a level of testing.  The table below shows the testing levels and current pricing.

Testing Level and Pricing

Test Level

Initial Cost

Upgrade additional cost
     
Y-DNA 12 markers

$106.00

  
Y-DNA 25 markers

$131.00

  
     Refine 12 to 25 markers  

$54.00
Y-DNA 37 markers

$156.00

  
     Refine 12 to 37 markers  

$104.00
     Refine 25 to 37 markers  

$54.00
Y-DNA 67 markers

$248.00

  
     Refine 12 to 67 markers  

$194.00
     Refine 25 to 67 markers  

$153.00
     Refine 37 to 67 markers  

$104.00
     

If you send a check, it should be in one of the amounts of shown in the table and made payable in US dollars to Dunham/Singletary Family Connections and mailed to the address at the top of the page.

Once you submit the data, you will be presented with an acknowledgement screen. If you wish to pay the testing fee electronically, you will be able to access the shopping cart from the acknowledgement page.  Payment through PayPal may minimize bank charges for non-US payments.

Testing Coordinator,
Paul C. Dunham [pcdunham@pcdunham.net]
406-443-3283


Revised 8/8/2010