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Y Chromosome Testing Application

From Dunham-Singletary Family Connections
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<emailform>
 
<emailform>
 +
{| class="wikitable" align="{{{align|center}}}"
 +
|-
 +
! Description
 +
! Price
 +
|-
 +
|Y-DNA 37 marker Test
 +
|$158
 +
|-
 +
|Y-DNA 67 Marker Test
 +
|$247
 +
 +
|-
 +
|Y-DNA 111 Marker Test
 +
|$348
 +
 +
|-
 +
|Refine 37 to 67 Markers
 +
|$99
 +
|-
 +
|Refine 67 to 111 Markers
 +
|$138
 +
|}
 
  {|  
 
  {|  
 
  | Full Name: || <emailform name=40 />
 
  | Full Name: || <emailform name=40 />
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  |-   
 
  |-   
 
  | Email: || <emailform email=40 />  
 
  | Email: || <emailform email=40 />  
|-
 
| Website: || <emailform website=40 /> || (optional)
 
 
  |-
 
  |-
 
  | Comments:
 
  | Comments:
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  |}
 
  |}
  
{| class="wikitable" align="{{{align|center}}}"
 
|-
 
! Description
 
! Price
 
|-
 
|Y-DNA 37 marker Test
 
|$158
 
|-
 
|Y-DNA 67 Marker Test
 
|$247
 
  
|-
 
|Y-DNA 111 Marker Test
 
|$348
 
 
|-
 
|Refine 37 to 67 Markers
 
|$99
 
|-
 
|Refine 67 to 111 Markers
 
|
 
|}
 
 
  </emailform>
 
  </emailform>
 
  <emailform result>
 
  <emailform result>
Thanks for your registration.  
+
Thanks for your participation in the DNA Testing Program.  
  
  Your information has been transmitted; Please complete payment for membership  via PayPal by clicking on the add to cart button.
+
Your information has been transmitted; You can pay for the test by clicking on the desired option below.  Optionally, you can mail your payment to the DNA Testing coordinator.
  
# Create Table with payment options.
 
  
 
{| class="wikitable" align="{{{align|center}}}"
 
{| class="wikitable" align="{{{align|center}}}"
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|$247
 
|$247
 
|<html>
 
|<html>
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<form target="paypal" action="https://www.paypal.com/cgi-bin/webscr"
 
<form target="paypal" action="https://www.paypal.com/cgi-bin/webscr"
 
 
method="post">
 
method="post">
 
<input type="hidden" name="cmd" value="_s-xclick">
 
<input type="hidden" name="cmd" value="_s-xclick">
 
<input type="hidden" name="hosted_button_id" value="XJL3KN9MYENY2">
 
<input type="hidden" name="hosted_button_id" value="XJL3KN9MYENY2">
 
<input type="image"
 
<input type="image"
 
 
src="https://www.paypalobjects.com/en_US/i/btn/btn_cart_LG.gif"
 
src="https://www.paypalobjects.com/en_US/i/btn/btn_cart_LG.gif"
 
 
border="0" name="submit" alt="PayPal - The safer, easier way to pay
 
border="0" name="submit" alt="PayPal - The safer, easier way to pay
 
 
online!">
 
online!">
 
<img alt="" border="0"
 
<img alt="" border="0"
 
 
src="https://www.paypalobjects.com/en_US/i/scr/pixel.gif" width="1"
 
src="https://www.paypalobjects.com/en_US/i/scr/pixel.gif" width="1"
 
 
height="1">
 
height="1">
 
</form>
 
</form>

Latest revision as of 13:27, 15 March 2018

Description Price
Y-DNA 37 marker Test $158
Y-DNA 67 Marker Test $247
Y-DNA 111 Marker Test $348
Refine 37 to 67 Markers $99
Refine 67 to 111 Markers $138
Full Name:
Street Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone Number :
Email:
Comments:




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