Once your samples are received the only correspondence you will have with The Genetics Company is via the address you provide.
|
|
- Cecily Harrison
- 8 years ago
- Views:
Transcription
1 Anonymous Infidelity DNA Test Instructions Thank you for your interest in an anonymous Infidelity DNA test. The Genetics Company guarantees to maintain your anonymity. This five page document will outline the steps necessary to correctly collect and package your samples. It is important that you carefully follow these instructions. You will collect your own samples using supplies you can find around the house. You will pay for your test with a money order and you will receive your results only in digital form. No paperwork will be sent to your home. Once your samples are received the only correspondence you will have with The Genetics Company is via the address you provide. Your anonymity is maintained by not providing your name to The Genetics Company. Please note that your DNA profile may be generated- your profile will be assigned a numeric identifier. Our laboratory is a private company and we do not share your profile with anyone for any reason. When packaging your samples for shipping we ask that you do not list your address for return. We do not want to know your address. You are responsible for shipping. No kits or results are sent by mail. Payment is made in the form of a money order. You should purchase this money order with cash to maintain your anonymity. Your final results will not have any personally identifying information on them. Anonymous test results are delivered by only. You will never receive mail or phone correspondence from The Genetics Company. We strongly recommend that you set up an alternative address for your correspondence with The Genetics Company.
2 Anonymous Infidelity DNA Test Instructions The following information is provided to assist you in completing the most accurate testing collection procedure possible. 1. Obtain the following supplies. One paper bag or envelope per evidence sample. Do not place samples in plastic. This can cause the DNA to degrade. One standard envelope to contain reference swab samples. Four q-tip cotton swabs or sterile cotton swabs - to collect your cheek swab DNA sample 2. Label and package the evidence sample(s). Label each envelope/bag with the following fields. Sample Type, Collection Date, Your name.next, place the evidence directly into the evidence envelope. Do not place any DNA samples in plastic. Seal the envelope with tape. Example Evidence Envelope 3. Collect your reference (swab) samples. If you are using q-tips you must prepare them. Prepare four swabs. Using a clean pair of scissors cut ONE end from each cotton swab. The end result will look like this: Label the standard envelope with the following information: Collection Date Your name Your race/ethnicity : Caucasian, Hispanic, Black, Asian, Native American instructions are continued on the next page
3 Anonymous Infidelity DNA Test Instructions Using a single swab that you have created (or removed from the wrapper) rub the inside of your cheek for 30 seconds with an up and down motion. Use moderate pressure and realize that you are removing skin cells from the inside of your mouth. The skin will stick to the cotton on the swab. This should not hurt. Place the swab in the envelope. Using a second swab rub the inside of your other cheek for 30 seconds with an up and down motion. Place the swab in the same envelope where you have placed the first swab. Repeat until you have collected four swabs. Seal the envelope with tape. 4. Complete the Infidelity Testing Agreement. You must send this form with your samples. You must sign this form. 5. Provide Payment, purchase a money order. Make payable to ATGC. 6. Prepare your samples and forms for shipping. Place samples and documents into separate paper envelopes. Place these individual envelopes in the sample larger shipping envelope/ box. Ship to: DNA Receiving AGTC 2942 N 24th St Suite 114 Phoenix AZ Upon receipt of your samples The Genetics Company will send you a sample receipt notification via . It will be sent from our secure address: wednesday908@gmail.com 8. Your results will be released in 6-8 working days. Results are only released to you by .
4 Anonymous Testing Agreement Complete this document and return it with your samples. Our Anonymous wednesday908@gmail.com Provide your Address - you will receive your results by only. Address We suggest that you set up a new account for use solely for our correspondence to maintain anonymity. We will not discuss your case by phone for anonymous testing. Loss of access to is your responsibility. eg. Red Panties, Blue Boxers, My Swabs Describe the Samples Choose the service(s). Semen Screening - chemical detection - mens ejaculate / stains DNA Detection - discover men s DNA from skin, saliva and ejaculate Semen Screen + DNA Detection - chemical and DNA detection DNA Comparison - Compare DNA from Stain to Your DNA - Advanced option Provide answers for the following security questions. What is your favorite color? What city were you born in? Please check the box to indicate that you consent to the terms listed below. By sending samples you are agreeing to the following terms. I hereby certify that I am 18 years of age or older and that I am voluntarily submitting these samples for DNA analysis or other testing and that the information I have provided is true and correct. I release ATGC, and its representatives and subcontractors, from any injury or harm, both physical and psychological, that may result from the test results as well as the collection of the samples, as well as from any actions that I, or others, may take after receiving the sample results. I agree to indemnify, hold harmless, and defend ATGC, and all officers, agents, employees and representatives from any and all claims, actions, damages, liabilities, and cost demands arising from any allegations that I did not have the right to or consent to taking any samples from the subjects on this form to perform testing. I understand that most test results are returned in the quoted time frame. Unless I have paid for RUSH results there is no guarantee of turnaround time. I understand that since the samples were not collected under a strict chain of custody by a neutral third party, and ATGC cannot verify the origin of the samples; this test may not be legally admissible. I also understand that these test results may or may not provide conclusive proof of infidelity. My personal information will not be used for any reason without my consent. For a full list of privacy practices visit- TGC does not have control over the nature of, integrity of, nor the legitimacy of the samples. Purchaser assumes all legal liability, all sales are final. Sample submission constitutes agreement to these terms and conditions. " " " " " 1
5 Anonymous Testing Payment Instructions By remitting payment you are agreeing to the terms listed on the Anonymous Infidelity Testing Agreement, and the privacy and guarantee policies at shecheated.net. Payment is due immediately: Payment must be sent with the samples. ALL SALES ARE FINAL Make money orders or cashier s checks payable to: ATGC Phoenix AZ ** No CASH ** ** No PERSONAL CHECKS ** Testing will not begin until full payment is received. Test Time Cost Semen Screening 6-8 lab days 150 DNA Detection 6-8 lab days 150 Semen + DNA Detection 6-8 lab days 250 DNA Comparison 6-8 lab days 330 Anonymous testing must be paid via money order. All correspondence with anonymous clients will be by only.
6 Anonymous Infidelity DNA Test Instructions Frequently Asked Questions Q. Why shouldn t I place my sample(s) in plastic? A: In some (not all) cases plastic will create a moist environment where bacteria and mold will grow. This will cause the DNA to degrade. Q: If I use the DNA detection and you find DNA can I upgrade to the DNA Comparison? A: Yes. We recommend that you send your swab DNA samples with every test in the event that you would like to upgrade. Q: How long will it take to get my results? A: Results are released an average of 6-8 days per testing cycle. The Genetics Company offers faster results- rush testing. Please contact us for pricing Q: Will I get the samples back? A: Samples are not routinely returned. Samples are held for 60 days and then discarded. If you wish to have your samples returned a small shipping fee will apply. Q: What do my results look like? A: Results are a forensic DNA report. The report is signed by a Certified Forensic Analyst and PhD. Q: What if I don t understand the results? A: A Case Manager is available by phone or to help. For anonymous cases we will only answer technical questions. Please do not hesitate to provide any additional information you feel is necessary to successfully complete your test. Your privacy is a top priority. Contact a Case Manager at with questions.
Collecting a Buccal Swab An Art or a Cinch? By Chantel Marie Giamanco, Forensic Scientist Human Identification Technologies, Inc.
Collecting a Buccal Swab An Art or a Cinch? By Chantel Marie Giamanco, Forensic Scientist Human Identification Technologies, Inc. An increasing number of cases tried in the courtroom involve DNA evidence.
More informationCITY OF CHESTERFIELD POLICE DEPARTMENT GENERAL ORDER 122-11 EFFECTIVE: MAY 5, 2011 CANCELS: GENERAL ORDER 122-07
CITY OF CHESTERFIELD POLICE DEPARTMENT GENERAL ORDER 122-11 EFFECTIVE: MAY 5, 2011 CANCELS: GENERAL ORDER 122-07 TO: ALL PERSONNEL INDEX AS: DNA EVIDENCE COLLECTION OF EVIDENCE EVIDENCE - DNA CRIME SCENE
More informationEvidence Preservation in Sexual Assault: Between the Crime Scene and the Medical Examination
Evidence Preservation in Sexual Assault: Between the Crime Scene and the Medical Examination Pacific Police Development Program Global Justice Solutions LOCARD S PRINCIPLE VICTIM CRIME SCENE OFFENDER Evidence
More informationDNA & CRIME VICTIMS: WHAT VICTIMS NEED TO KNOW
DNA & CRIME VICTIMS: WHAT VICTIMS NEED TO KNOW DNA & CRIME VICTIMS: What Victims Need to Know The increasing use of DNA evidence in criminal cases gives victims of crime new hope that offenders will be
More informationDear Accelerated BSN Applicant:
Dear Accelerated BSN Applicant: Thank you for your interest in our accelerated BSN program. I commend you for your decision to further your education, advance your career, and prepare yourself for leadership
More informationThe University of Texas Southwestern Medical Center at Dallas Retina Foundation of the Southwest CONSENT TO PARTICIPATE IN RESEARCH
The University of Texas Southwestern Medical Center at Dallas Retina Foundation of the Southwest CONSENT TO PARTICIPATE IN RESEARCH Title of Research: Funding Agency/Sponsor: Study Doctors: Research Personnel:
More informationYOUR CONTACT DETAILS (ADDRESS, PHONE, EMAIL etc.):
Justice WA YOUR NAME: YOUR CONTACT DETAILS (ADDRESS, PHONE, EMAIL etc.): TODAY S DATE: INDICATE WHO IS COMPLETING THIS FORM: Defendant Family Member of Defendant (Relationship : ) Friend of Defendant Other:
More informationPolicy Holder Name Relationship to Patient SSN DOB
Orthopedic Today s Date Patient s SSN# Legal First Name Last Name M.I. DOB Gender Parent/Guardian Name (for pediatrics) DOB Address City State Zip Home Phone Cell Phone Work Phone Email Have any members
More informationTouch DNA and DNA Recovery. H. Miller Coyle
Touch DNA and DNA Recovery 1 2 What is the link between cell biology & forensic science? Cells are the trace substances left behind that can identify an individual. Cells contain DNA. There are two forms
More informationSustainable Building Science Technology
Sustainable Building Science Technology Bachelor of Applied Science Program APPLICATION FOR ADMISSION FALL 2016 1 st Review Due Date: May 13, 2016 Applications received after the first review will be accepted
More informationLifeline Applicant. Please return the completed application & fee to: Simi Valley Hospital Lifeline Program 2975 N. Sycamore Dr. Simi Valley CA 93065
Lifeline Applicant Please return the completed application & fee to: Simi Valley Hospital Lifeline Program 2975 N. Sycamore Dr. Simi Valley CA 93065 You must have a landline phone (not just a cell phone)
More informationSAMPLE COLLECTION MANUAL
SAMPLE COLLECTION MANUAL Revised and Updated v.2 February 2005 Table of Contents I. INTRODUCTION...1 NEW YORK STATE COLLECTIONS...1 II. COMPANY OVERVIEW...2 III. SAFETY...3 Universal Precautions (UP)...3
More informationQuick Start Contents
Quick Start Guide 1 Quick Start Contents Contact Information.. 3 Create an Account 3 Order Saliva Collection Supplies...3 Collect a Specimen..4 Order a Test..5 Package and Ship Specimens...8 Schedule FedEx
More informationCentre of Forensic Sciences Investigators & Submitters Technical Information Sheets
Centre of Forensic Sciences Investigators & Submitters Technical Information Sheets Body Fluid Information Introduction Examinations are conducted based on their scientific merit in the context of the
More informationFIRST TIME HOMEBUYERS PROGRAM APPLICATION 75 College Avenue, 4 th Floor, Rochester, NY 14607 585-546-3700 3019 fax 585-546-2946
FIRST TIME HOMEBUYERS PROGRAM APPLICATION 75 College Avenue, 4 th Floor, Rochester, NY 14607 585-546-3700 3019 fax 585-546-2946 Applicant 1: Applicant 2: Home Ph# ( ) Work Ph# ( ) Cell Ph# ( ) Social Security
More informationChain of evidence refers to the continuity of custody of material and items collected as evidence.
University of Wisconsin Madison Police Policy: 83.2 SUBJECT: EVIDENCE PROCESSING EFFECTIVE DATE: 06/01/10 REVISED DATE: 12/31/11, 11/01/13 REVIEWED DATE: 01/07/15 INDEX: 83.2.1 COLLECTING, PROCESSING,
More informationPIN3/PIN3plus Satisfaction Survey
PIN3/PIN3plus Satisfaction Survey We want to thank you once again for all you have done to make our study successful and help us to better understand and improve health during pregnancy. Now that your
More informationAUBURN SMALL BUSINESS LOAN PROGRAM APPLICATION CHECKLIST
OFFICE USE ONLY Date Received: AUBURN SMALL BUSINESS LOAN PROGRAM APPLICATION CHECKLIST Fill out and sign the loan application completely and return with all required documentation to: Community Development
More informationMOTION TO CHANGE CUSTODY
FD/FOC 4018 MOTION TO CHANGE CUSTODY USE THIS SET OF FORMS IF: You still have at least one child on this case that is under 18 years old You want to change physical custody of the child(ren) in your case
More informationProfessional Technical Teacher Education Bachelor of Applied Science Program
Professional Technical Teacher Education Bachelor of Applied Science Program APPLICATION FOR ADMISSION FALL 2016 1 st Review Due Date: May 13, 2016 Applications received after the first review will be
More informationCash Letter Deposit Service Guide
Cash Letter Deposit Service Guide July 2005 Table of Contents Cash Letter Deposit Service Overview...3 Introduction...3 Cash Letter Pre-Encoded Deposit Workflow...4 Cash Letter Un-Encoded Deposit Workflow...5
More informationCrime Scene and Case Processing. Biological Screening
Crime Scene and Case Processing Crime Scene and Case Processing Includes: Types of evidence Crime scenes Location and collection of evidence Collection techniques Preservation of evidence Packaging and
More informationMillers College of Nursing 2151 Consulate Drive Suite, 10 & 11 Orlando, FL 32837
Congratulations on your decision to pursue your degree in nursing. The Millers College of Nursing offers a career pathway to the Bachelor of Science in Nursing. The pathway provides learning activities
More informationTown of Maiden. Request for Proposals For Sign Replacement Project
Town of Maiden 19 N. Main Avenue Maiden, NC 28650 (828) 428-5000 Request for Proposals For Sign Replacement Project Section I Introduction and Intent of RFP: Pursuant to the General Statutes of North Carolina
More informationSTATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH ASBESTOS Contractor License Application
STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH ASBESTOS Contractor License Application General Policies and Procedures IMPORTANT: THE DEPARTMENT WILL NOT REVIEW HAND-DELIVERED APPLICATIONS AT THE TIME
More informationDNA paternity and relationship testing services
analytical quality measurement accuracy regulatory testing chemical measurement bioanalysis standards forensic testing DNA paternity and relationship testing services Contents 1 Why choose LGC to carry
More informationApplication for Graduate Study
Application for Graduate Study Expected Registration Year: Graduate Program: Name: Maiden: Address: City: County: State: Zip: Are you a U.S. Citizen? Yes No Nation of Citizenship: If no: Green Card Degree
More informationGeneral Membership Handbook
General Membership Handbook Revised: December 22, 2010 Table of Contents 1. Membership as a Research Scientist A. Membership Requirements B. Eligibility C. Application Process D. Fees E. Renewal Process
More informationBID DOCUMENTS FOR LAUNDERING, PRESSING & DRY CLEANING SERVICES FOR THREE-YEAR TERM
BID DOCUMENTS FOR LAUNDERING, PRESSING & DRY CLEANING SERVICES FOR THREE-YEAR TERM CITY OF OWOSSO 301 W. MAIN STREET OWOSSO, MICHIGAN 48867 May 5, 2014 NOTICE TO BIDDERS LAUNDERING, PRESSING & DRY CLEANING
More informationCOUNTY OF YUBA REQUEST FOR PROPOSAL SOUTH ANNEX BUILDING ASBESTOS ABATEMENT. Due Date: November 13, 2009 Time: 2:00 PM, PST.
COUNTY OF YUBA REQUEST FOR PROPOSAL SOUTH ANNEX BUILDING ASBESTOS ABATEMENT Due Date: November 13, 2009 Time: 2:00 PM, PST. October 19, 2009 To: All Interested Vendors Re: Request for Proposals, County
More informationQ: Why is there a need for people to join the Be The Match Registry?
Q: Why is there a need for people to join the Be The Match Registry? A: Thousands of patients with blood cancers like leukemia and lymphoma, sickle cell and other life-threatening diseases depend on the
More informationCompany Name: Order Address:
This box for MH Use Only VENDOR DATA SHEET REQUIRED MH Vice President signature: Company Name: Order Address: City: State: Zip Code: Customer Service Information: Contact Phone: Fax: **Does your ordering
More informationCheck Sheet with General Guidelines-Application for Admission Fall 2012 (start upper-division Fall 2012)
The University of North Alabama College of Nursing and Allied Health (CONAH) Application for Admission Fall 2012 (start upper-division Fall 2012) Applications will only be accepted 8:00 am February 1 st
More informationUsing a Microscope to See Different Types of Cells
Using a Microscope to See Different Types of Cells copyright 2003 by Dr. Vivianne Nachmias, University of Pennsylvania All organisms are made up of cells - a cell is the simplest collection of matter that
More information6 Body Fluid Stains and Standards
6 Body Fluid Stains and Standards Laboratory examination of body fluids (i.e., blood, semen, saliva, etc.) may produce significant information in certain investigations. This chapter considers the recognition,
More informationKindly allow me to showcase our services as to how it can help you to get your valuable data recovered.
Dear Customer, Thank you for choosing Stellar Data Recovery Inc. Pioneers and one of the leading providers of Data Recovery and Data safety solutions globally since 1993. We have had the privilege to serve
More information**Incomplete vendor registration submissions will be discarded after 30 days.**
**Incomplete vendor registration submissions will be discarded after 30 days.** Procurement Services Department 130 Trinity Avenue, 4 th Floor Atlanta, GA 30303 Fax (404) 802-1506 Vendor Registration Form
More informationCredentialing Application for Dental Services and/or Anesthesia Service
STATE OF TENNESSEE DEPARTMENT OF INTELLECTUAL AND DEVELOPMENTAL DISABILITIES Credentialing Application for Dental Services and/or Anesthesia Service Provider qualification specified in the Home and Community
More informationState of Oklahoma COUNCIL ON LAW ENFORCEMENT EDUCATION AND TRAINING Private Security Licensing Division
State of Oklahoma COUNCIL ON LAW ENFORCEMENT EDUCATION AND TRAINING Private Security Licensing Division CLEET Private Security Division Ada, Oklahoma 74820-0669 (405) 239-5100 Dear Agency Applicant: Thank
More informationAPPLICATION FOR EMPLOYMENT
APPLICATION FOR EMPLOYMENT Dallas Summer Musicals/DSM Management Group is committed to providing equal opportunity in all employment practices, including but not limited to selection, hiring, promotion,
More informationBehavior Analyst License ***************************************************************** License Requirements: APPLICATION INSTRUCTIONS
MARYLAND BOARD OF PROFESSIONAL COUNSELORS AND THERAPISTS Behavior Analyst License ***************************************************************** License Requirements: The applicant shall: (1) Have a
More informationCRIME SCENE PROCEDURES III.
CRIME SCENE PROCEDURES III. Evidence Collection... 2 Collection Methods... 3 Evidence Marking and Packaging... 4 Establishing the Chain of Custody... 4 Reporting... 6 Evidence Collection Investigators
More informationThe Certification Application Process. Page 2. The Mandatory Deadline.. Page 3. The Status Verification Letter. Page 3
UAB CERTIFICATION HANDBOOK for Ed.S. STUDENTS Congratulations! You are nearing the end of your preparation to advance your Class A Professional Educator or Leadership certificate to a Class AA Professional
More informationCENTRAL AIR CONDITIONER REBATE
Thank you for your participation and interest in saving energy. By installing qualifying high-efficiency equipment in your home, you can receive rebates and save on energy costs. Please follow the steps
More informationCONSENT TO PARTICIPATE IN A CLINICAL RESEARCH STUDY
The Feinstein Institute for Medical Research North Shore-Long Island Jewish Health System (NS-LIJHS) TITLE OF PROTOCOL: Genetics and Epidemiology of Absolute Pitch and Related Cognitive Traits Principal
More informationActivity 4 Long-Term Effects of Drug Addiction
Activity 4 Long-Term Effects of Drug Addiction Core Concept: Addictive drugs may lead to long-term changes in brain function. Class time required: Approximately 60-80 minutes Teacher Provides: Copy of
More informationWHEN TO APPLY APPLICATION REGISTRATION TB SKIN TEST STANDARDIZED TESTS GRADUATE MANAGEMENT ADMISSION TEST (GMAT)
Application for Admission P.O. Box 519, MS 2320 Phone: (936) 261-9217 Fax: (936) 261-9232 WHEN TO APPLY For admission to a master's program, at least 2 months should be allowed for processing. International
More informationRequest for Quotation
City of Richmond Business and Financial Services Department Request for Quotation Supply and Delivery of NETWORK SWITCHES Bidders are requested to respond to this Quotation call as instructed subject to
More informationCOVENTRY PUBLIC SCHOOLS PHOTOGRAPHY BID
COVENTRY PUBLIC SCHOOLS PHOTOGRAPHY BID PROJECT: To Provide Photography Services for School Pictures to Coventry Public Schools. The School District is comprised of (5) Elementary Schools with total enrollment
More informationwww.cadatarecovery.net
CA DATA RECOVERY, INC. 980 9 th street, 16 th floor Sacramento California 95814 (916) 825-2220 ph. (916) 405-4411 fax REQUEST FOR SERVICE Non-Server, Individual drive DATE CUSTOMER NAME COMPANY NAME PHONE
More informationRequest for Quote Number: 2015-06-PRC Baseball Diamond Backstop Re-Fence
Request for Quote Number: 2015-06-PRC Baseball Diamond Backstop Re-Fence Sealed request for quotes will be received by Brian Tocheri, CAO/Clerk at 341 10 th St. Hanover, Ontario, N4N 1P5 until 2:00 pm,
More informationFACT SHEET. Involuntary Transfer of Ownership of a Vehicle by Court Order
FACT SHEET Involuntary Transfer of Ownership of a Vehicle by Court Order PURPOSE This Fact Sheet outlines the procedures that must be followed when applying for a Certificate of Title involving the involuntary
More informationSummer 2015 Youth STEM REGISTRATION PACKET
Summer 2015 Youth STEM REGISTRATION PACKET Oakton Community College Alliance for Lifelong Learning and Center for Promoting STEM 1 Table of Contents OAKTON YOUTH STEM OVERVIEW...3 PROGRAM STRUCTURE...3
More informationAPPLICATION FOR ADMISSION PHARMACY TECHNICIAN PROGRAM DIXIE APPLIED TECHNOLOGY COLLEGE
APPLICATION FOR ADMISSION PHARMACY TECHNICIAN PROGRAM DIXIE APPLIED TECHNOLOGY COLLEGE You must apply for formal admission to the Pharmacy Technician Program at the Dixie Applied Technology College (DXATC).
More informationHow To Use Dna Evidence At Trial
JOURNAL ISSUE NO. 249 / JULY 2003 DNA Evidence: What Law Enforcement Officers Should Know Proper use of DNA (deoxyribonucleic acid) evidence at trial can help to seal a conviction or obtain an acquittal.
More informationSMALL BUSINESS MOBILIZATION LOAN APPLICATION
SMALL BUSINESS MOBILIZATION LOAN APPLICATION All applicants must complete the Application in its entirety. The Guidelines section contains information on the Loan Program Parameters, the Loan Applications
More informationConroe Physician Associates. Patient Consent Form. I fully understand that this is given in advance of any specific diagnosis or treatment.
Conroe Physician Associates Patient Consent Form Please Read and Sign I, undersigned, hereby consent to the following: Administration and performance of all treatments Administration of any needed anesthetics
More informationIf you are signing for a minor child, you refers to your child throughout the consent document.
CONSENT TO PARTICIPATE IN A CLINICAL RESEARCH STUDY Adult Patient or Parent, for Minor Patient INSTITUTE: National Cancer Institute PRINCIPAL INVESTIGATOR: Raffit Hassan, M.D. STUDY TITLE: Tissue Procurement
More informationTraining on Standard Operating Procedures for Health Care Waste Management Swaziland 12 May, 2011
Training on Standard Operating Procedures for Health Care Waste Management Swaziland 12 May, 2011 Safe Infectious Waste Handling and Transport Objective Waste Overview Roles and Responsibilities of Waste
More informationMAJOR EQUIPMENT PURCHASE CONTRACT
MAJOR EQUIPMENT PURCHASE CONTRACT CONSUMERS ENERGY COMPANY ONE ENERGY PLAZA JACKSON, MI 49201 ( Buyer ) ( Seller ) Date:, 20 Subject to the provisions of this Major Equipment Purchase Contract ( Contract
More informationNOT PROTECTVELY MARKED
Force Template NOT PROTECTIVELY MARKED Policy Title: DNA Policy, Procedure and Guidance CCMT Sponsor ACC Specialist Operations Department/Area: Crime Support Section/Sector: Forensic Investigations Unit
More informationSOCIAL SECURITY ADMINISTRATION Application for a Social Security Card
SOCIAL SECURITY ADMINISTRATION Application for a Social Security Card Applying for a Social Security Card is easy AND it is free! USE THIS APPLICATION TO APPLY FOR: An original Social Security card A duplicate
More informationPART I YOUR INFORMATION/CO-APPLICANT INFORMATION. Name (Last, First, MI): City: State: Zip: Years at above Address: Do you: Rent
APPLICANT Massachusetts Assistive Technology Loan Program Easter Seals MA, 484 Main Street, Worcester, MA 01608 Phone: (800) 244 2756 x 428 or 431 Fax: (508) 751 6444 Program Loan Application App #: PART
More informationTEACHERS INSURANCE AND ANNUITY ASSOCIATION OF AMERICA TIAA-CREF LIFE INSURANCE COMPANY. Important Information About Transferring Ownership
Page 1 of 4 Important Information About Transferring Ownership Designating Your Beneficiary An Ownership Transfer does not automatically change the beneficiary. Upon completion of this transfer, the new
More informationJerry M. Ruhl Ph.D. Clinical Psychologist (Texas #34359) 5200 Montrose Blvd. Houston, TX 77006
Jerry M. Ruhl Ph.D. Clinical Psychologist (Texas #34359) 5200 Montrose Blvd. Houston, TX 77006 CELL (937) 684-7746 PLEASE USE THIS NUMBER TO SCHEDULE OR CHANGE APPOINTMENTS INFORMED CONSENT FOR TREATMENT
More informationThank you for your interest in the Summer Nursing Intern Program at Johnson Memorial Health Services.
Name: Thank you for your interest in the Summer Nursing Intern Program at Johnson Memorial Health Services. Please complete the application packet. Interns must be enrolled in a summer internship course
More informationFREQUENTLY ASKED QUESTIONS Oral Fluid Drug Testing with Oral-Eze
FREQUENTLY ASKED QUESTIONS Oral Fluid Drug Testing with Oral-Eze BENEFITS AND PRICING Q: What benefits does Oral-Eze present? A: The Oral-Eze Oral Fluid Collector has a built-in indicator for determining
More informationHOW TO OBTAIN A NEW CONTRACTOR LICENSE
HOW TO OBTAIN A NEW CONTRACTOR LICENSE These instructions apply to new licenses only. If you wish to add a classification or a qualifying party to an existing license, please see HOW TO ADD A CLASSIFICATION
More informationNorth Carolina A&T State University Sebastian Health Center 1601 E. Market Street Greensboro, NC 27411 336-334-7880 Office 336-256-2613 Fax
North Carolina A&T State University Sebastian Health Center 1601 E. Market Street Greensboro, NC 27411 336-334-7880 Office 336-256-2613 Fax GUIDELINES FOR COMPLETING THE REQUIRED MEDICAL HISTORY PACKET
More informationBartow County C.E.R.T.
Dear Applicant, I would like to take this opportunity to thank you for your interest in the Community Emergency Response Team. The CERT Program is presented by the Bartow County Emergency Management Agency
More informationYour Specialty Medication Handbook
Your Specialty Medication Handbook What s Inside Welcome... 3 You can count on special care... 4 Specialty medications present special challenges Get support from the specialty care management program
More informationIndicate on the envelope containing your bid the following information: Bid on Forest Products, Harbison
Harbison State Forest Forest Products Sale Sealed lump sum bids will be accepted until May 8 th 2012, by the South Carolina Forestry Commission, for the sale of approximately 135 acres of timber consisting
More informationSTATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH ASBESTOS Worker and Supervisor Application
STATE OF CONNECTICUT ASBESTOS Worker and Supervisor Application General Policies and Procedures IMPORTANT: THE DEPARTMENT WILL NOT REVIEW HAND-DELIVERED APPLICATIONS AT THE TIME OF RECEIPT. PROFESSIONAL
More informationCity of Kennedale c/o Art in the Park 405 Municipal Drive Kennedale, TX 76060
Dear Art Festival Applicant: The Art in the Park Committee and the City of Kennedale invite you to apply to participate in the Fifth Annual Art in the Park Arts Festival to be held April 4 6, 2014. Please
More informationAquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms
Aquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms All forms and payment are due no later than June 15, 2015 Note: There is a $25 non-refundable registration fee, and no refunds
More informationEQUIPMENT LOAN REQUEST FORM
City of Portsmouth Parks, Recreation, and Leisure Services 801 Crawford Street Portsmouth, VA 23704 757-393-8481 The Department of Parks, Recreation, and Leisure Services may loan equipment to eligible
More informationOffice of Graduate Admission 2083 Lawrenceville Road Lawrenceville, NJ 08648-3099 T 609-896-5036 www.rider.edu
Office of Graduate Admission 2083 Lawrenceville Road Lawrenceville, NJ 08648-3099 T 609-896-5036 www.rider.edu APPLICATION INSTRUCTIONS First-time applicants for graduate study must submit: 3 This application,
More informationThe Illinois Law Enforcement Intern Training Program Application for Admission
The Illinois Law Enforcement Intern Training Program Application for Admission Instructions for completion of application: 1. Please print or type in black ink. 2. Do not leave any question blank. If the
More informationDevice Loan General Instructions. Borrower s General Responsibility and Liability Statements. Returning Device(s) Loaned
Device Loan General Instructions Please read and sign the three forms included in this packet 1. Device Loan Request Form (pages 2-3) 2. Borrower s Responsibility and Liability (page 4) 3. Release of Liability
More informationVan Buren County Homeowner Rehabilitation Loan Program Pre-Application
Van Buren County Homeowner Rehabilitation Loan Program Pre-Application Thank you for inquiring about the Van Buren County homeowner rehabilitation program. Funds for this program come from the Michigan
More informationREQUEST FOR PROPOSAL THIRD PARTY ADMINISTRATOR FOR TAX SHELTERED ANNUITIES
REQUEST FOR PROPOSAL THIRD PARTY ADMINISTRATOR FOR TAX SHELTERED ANNUITIES I. BACKGROUND The Marlboro County School District, hereinafter referred to as District is seeking a firm to act as a Third Party
More informationSHORT FORM For Use by presently certified firms.
Economic Development Department Minority and Women-Owned Business Enterprise Certification Application SHORT FORM For Use by presently certified firms. M/WBE Certification Application, Short Form Rev.
More informationStudent Drug & Alcohol Testing Policy for Extracurricular Activities
Student Drug & Alcohol Testing Policy for Extracurricular Activities The Geary Board of Education, in an effort to protect the health and safety of its students from illegal drug and/or alcohol use and
More informationNo question is too small or unimportant. 1-800-228-7151. Visit us at: http://www.ucfactors.com
Thank you for inquiring about our services, please contact us with any questions you might have regarding our factoring package. No question is too small or unimportant. 1-800-228-7151 Visit us at: http://www.ucfactors.com
More informationCertified Peer Counselor Training Application
Certified Peer Counselor Training Application Instructions Please type or print clearly. All sections of the form must be completed for the application to be accepted. These instructions explain how to
More informationNurse Aide I Program
Course Overview: The Nurse Aide I Program is a 144-hour non-credit course providing you with the skills to work as a Certified Nurse Aide I. You will learn fundamental patient care skills in classroom,
More informationEPS EFT Enrollment Authorization Agreement
EPS EFT Enrollment Authorization Agreement Optum is improving service to you by replacing paper checks and Explanation of Benefits (EOBs) with the Optum EPS solution. Get a head start by enrolling today!
More informationIMPORTANT: PLEASE READ THE INFORMATION BELOW
3-7 Day Processing IMPORTANT: PLEASE READ THE INFORMATION BELOW COMMERCIAL CREDIT APPLICATION CORLISS RESOURCES, INC. PO BOX 487 SUMNER, WA 98390 PHONE: 253-826-8014 FAX: 253-501-1622 Listed below are
More informationApplying for a Social Security Card is easy AND it is free!
SOCIAL SECURITY ADMINISTRATION Application for a Social Security Card Applying for a Social Security Card is easy AND it is free! USE THIS APPLICATION TO APPLY FOR: An original Social Security card A replacement
More informationMINORS ON CAMPUS. 1. Supervision, Background Investigations, Compliance with Laws and Rules:
MINORS ON CAMPUS Required Provisions in Affiliation Agreements/Contracts [Appendix D] 1. Supervision, Background Investigations, Compliance with Laws and Rules: (A) Licensee shall, at licensee s sole cost
More informationCouncil of Colleges of Acupuncture and Oriental Medicine. Clean Needle Technique Course Application Packet
Council of Colleges of Acupuncture and Oriental Medicine Clean Needle Technique Course Application Packet Dear CNT Applicant, Thank you for your interest in the Clean Needle Technique (CNT) course, administered
More informationSingle Married Divorced Widowed Student Minor African American Asian Caucasian Hispanic Other:
At both New Tampa Foot & Ankle AND South Tampa Foot & Ankle, we are committed to getting you back on your feet free of pain and injury so that you can get back to your activities and back into life! We
More informationThe School District of Philadelphia Standard Terms for Research Data License Agreements
The School District of Philadelphia Standard Terms for Research Data License Agreements The School District of Philadelphia (the School District ) has received and carefully considered your request for
More information* Do you wish to receive our monthly newsletter? Yes No Marital Status: Single Married Legally Separated Divorced Other Employer Name: (If applicable)
Doctor: Patient Name: Address: State: Date of Birth: Home Phone: Work Phone: Zip: Patient Demographics Maiden Name: City: Social Security Number: Cell Phone: Email Address: * Do you wish to receive our
More informationRowan University s Aim High Science and Technology Academy
s Aim High Science and Technology Academy (residential) Summer Science and Technology Program for Rising Seniors (Current 11th Graders) July 5, 2015 - July 31, 2015 (Sunday-Friday) STUDENT APPLICATION
More informationIn Your Blood Forensic DNA Databases
Irish Council for Bioethics In Your Blood Forensic DNA Databases DAVID NICHOLLS / SCIENCE PHOTO LIBRARY Q1 What is DNA? Q4 What is a DNA database? DNA stands for deoxyribonucleic acid. It is a chemical
More informationIncorporating Today's Small Businesses
Incorporating Today's Small Businesses Our Service Parcorp Services offers complete and affordable formation services to small businesses and professional throughout the United States. Simply fill in the
More informationOnline Executive MBA Program Application for Admission
Online Executive MBA Program Application for Admission Overview Congratulations on your decision to apply to the Online Executive MBA program at Rochester Institute of Technology. The following guide is
More informationHAMILTON COUNTY SCHOOL DISTRICT
HAMILTON COUNTY SCHOOL DISTRICT REQUEST FOR PROPOSALS FOR SPEECH/LANGUAGE THERAPY SERVICES PROPOSAL RETURN DATE May 25, 2016 AT 3:00 P.M. INVITATION TO BID Hamilton County School Board Betty Linton, Coordinator
More informationWHITTIER COLLEGE. Application for Admission Teacher Credential Program. Department of Education & Child Development
WHITTIER COLLEGE Department of Education & Child Development Application for Admission Teacher Credential Program 13406 E. Philadelphia Street P.O. Box 634 Whittier, CA 90608 562-907- 4248 Fax: 562-464-
More information