GenderLabs[TM] - Contribution Form

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Instructions

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MEMBERSHIP FORM

MEMBER PARTICULARS

First Name		Last Name
Address

City		State/Province
Zip/Post Code		Country
Phone		Fax
Email

MEMBERSHIP PREFERENCE

Let us know what Username and Password would you like to have in order for you to log into the Member Lounge after your membership has been approved.

NB: Username and password are case sensitive

Username
Password

CONTRIBUTION AMOUNT

Please let us know what is the amount you wish to contribute? You may choose to contribute in either US fund or Canadian fund (Minimum USD$10.00 or CAD$15.00)

Contribution Amount

CONTRIBUTION INSTRUCTIONS

Ensure all information is valid especially your email address as your personal Username and Password as well as a Serial Number (for registration of GenderLabs™ Fertility Management System) will be emailed to you directly.
Print a hard copy and make sure the contents are legible and,
Prepare check, money order or bank draft payable to Areddot Inc. (commercial arm of GenderLabs.com) for the amount in either US Fund or Canadian Fund which you have indicated earlier.
Send the payment together with the Membership Form by mail to Areddot Inc. with address as below: -

	ARedDot Inc.
	314A Queen Street East
	Toronto, ON M5A 1S8
	Canada