Pennington Research Association

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Pennington Research Association, Inc.
DNA Study
Volunteer DNA Tissue Donation Form

Please enter your information in the boxes below. Once you have completed filling in this form, print it by using your browser's print command. When it has printed, click the "Submit" box at the bottom of the form. You will receive a confirmation message. Your information will be sent to Nick Penington , Chairman of the DNA Study Group. He will then send you an e-mail message with the mailing instructions. Since this form appears in a new browser window, close it when you have completed all the instructions. You can then resume in the previous browser window.

Please complete the form below. All information is required. In the present phases of the study, volunteers will be sought who are able to pay the $148 (25 marker test) it will cost to have their own Y chromosome analysis performed.

First Name:

Last Name:

Street Address:

City:

State:

ZIP:

Telephone:

E-mail (if applicable):

Important Note: There is no requirement for male volunteers to be PRA members but this is encouraged especially if this test shows you belong to a PRA Group. Are you a current PRA Member?

Important Note: Are you reasonably certain that you are a member of a specific PRA Family Group? If Yes, then which Family Group? (Family Group Number)

Do you want to receive a personal and confidential report on your analysis?

If several identical DNA signatures are obtained from other members of your family group, and your tissue specimen has not been analyzed, would you allow the Research Group to use your money for another family group analysis?

Volunteers should understand that their analysis may not match others in their family group because of a non-paternal event at some point in the past.

We encourage volunteers to select the 25 marker test because the results are of more value to our study. In fact for most Penningtons the 12 marker test does not really have enough resolution but it can determine if you do not match anyone currently in the database.

The 25 marker test cost is $148 (plus $2 for shipping and handling)

Please select which DNA test you want to participate in:

Please enclose check or money order for $171 (25 marker test) payable to “Pennington Research Association, Inc.”, memo “DNA Project”. Your cancelled check will be acknowledgement of receipt. A tissue sampling kit will be mailed to you.

Your donation may be tax deductible. Click here to learn about PRA's Not-for-Profit Tax Status

The DNA Research Group is grateful for your participation.

*Important Notice: I/We give consent to the PRA to use my DNA, my name, mailing address, telephone number and e-mail address for this DNA Study.

Instructions

Enter your information in the boxes above.
Print this form.
Click the "Submit" Button (below) - You will see a confirmation page.
Click "Return to Form" button.
Close this web browser window.

Within a short time (4 or 5 days), you will receive an e-mail message from Nick Penington , DNA Study Group Chairman, confirming he has received your information and providing you with the mailing address.

Once you have the mailing address, enclose your COMPLETED DNA consent form AND your check and mail them to the address Nick Penington gives you.

If you have any questions or need help, please contact Gene Pennington , Research Director.

Corporation Information

The Pennington Research Association, Inc. is a not-for-profit charitable corporation as defined in section 501 (c) (3) of the Internal Revenue Code. Donors may deduct contributions to the Pennington Research Association as provided in section 170 of the Internal Revenue Code. Bequests, legacies, devises, transfers, or gifts to the Pennington Research Association are deductible for Federal estate and gift tax purposes if they meet the applicable provisions of sections 2005, 2106, and 2522 of the Internal Revenue Code.

Page Last Updated: 09/05/2006

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