Application Form

DNA 101: Y-DNA

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DNA 103: Grouping Participants

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Application Form

BLAIR DNA PROJECT APPLICATION FORM
(For all BLAIRs and variant spellings)

I have read about the BLAIR DNA Project which is described on the website located at http://blairdna.com/ and I would like to participate. I understand that the results of this test may help determine whether or not the project participants are descended from a common ancestor, and I understand that a specific ancestor will not be targeted. Since the BLAIR name is so widely used, there will be more than one family line identified.

Please enter the personal information below EXACTLY the way the shipping label and certificate should be printed.

Do NOT enter any web addresses (urls) into this form or the form will be REJECTED
Use the "Tab" key to move through the form DO NOT use the "ENTER" Key Pressing the "ENTER" Key will SUBMIT the form
First Name		(required)
Middle Name
Last Name		(required)
Address1		(required)
Address2
City		(required)
State or Other		(required)
Postal Code		(required)
Country		(required)
Phone - Fax		(xxx) xxx-xxxx
Email		(required)
Type of Test
Would you like to Subscribe to the Family Tree DNA Email Newsletter?

Please read the Participation Agreement below and check each block. Orders will NOT be placed unless ALL boxes are checked.
Participation Agreement
Yes, I want to sign up and I am willing to pay for the analysis of my DNA sample. The cost of the Y-DNA37 Marker test is $149.00 + p/h, the cost of the Y-DNA67 Marker test is $248.00 + p/h and the cost of the Y-DNA111 Marker test is $339.00 + p/h. I am enclosing my completed Pedigree Chart, which contains my male BLAIR line back to my earliest known BLAIR ancestor. (If you can trace your ancestor back farther than your great great grandfather, please use two sheets). I have included dates and places of birth when known, where they resided and the name of spouse, to enable you to match potential family lines. THE PEDIGREE CHART IS REQUIRED. I agree to release my project code number, ancestor's name, ancestor's chronology, ancestor's location, and DNA markers for publication on the BLAIR DNA Project web pages. No information concerning my identity may be published or released without my written permission. I have read the Release of Liability/Liability Waiver and agree that by participating in this project I am releasing both blairdna.com and the BLAIR DNA Project Family Coordinator (John A. Blair) of any legal issue which may arise out of my participation. This includes but is not limited to emotional impacts from an unanticipated DNA sequence result, samples being lost in transit, and poor samples being provided.

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How did hear about the Project? If Other?
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This WebPage was last updated 04/05/2015

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[ Introduction ] [ DNA 101 ] [ DNA 102 ] [ DNA 103 ] [ Project Updates ] [ Test Results ] [ Blair DNA Fund ] [ Application ] [ Pedigree Chart ] [ Info Release Form ] [ Participants ] [ Oldest Ancestors ] [ FTDNATip TMRCA ] [ Blair DNA FAQ ] [ Release of Liability ] [ Blair Society Lines ]

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