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Shipping address Option1
Title*	Select Mr Mrs Miss Ms
Name and Surname*
Company/Business Name (if applicable)
Street Address*
City/Town*
State or County/ Postcode*	State/County* Postcode*
Country**	Abkhazia Afghanistan Akrotiri and Dhekelia Åland Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Ascension Island Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Botswana Bosnia and Herzegovina Brazil Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Chad Cape Verde Cayman Islands Central African Republic Chili China Christmas Island Cocos (Keeling)Islands Colombia Comoros Congo, Democratic Republic of Congo, Republic of Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Finland Fiji France French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea - North Korea - South Kosovo Kuwait Kyrgyz Republic Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Cyprus Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philipines Pitcairn Islands Poland Portugal Pridnestrovie Puerto Rico Qatar Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Vietnam Saint Vincent and the Grenadines Samoa San Marino São Tomé Saudi Arabia Senegal Serbia Sierra Leone Seychelles Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Korea South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Tajikistan Tanzania Taiwan Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands United States Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Not Listed in website
Telephone
Email address*
Shipping address Option2 *Please fill in the following fields in the case that another participating individual resides at a different address.
Title	Select Mr Mrs Miss Ms
Name and Surname
Street Address
City/Town
State or County/ Postcode	State/County Postcode
Country	Abkhazia Afghanistan Akrotiri and Dhekelia Åland Albania Algeria American Samoa Andorra Angola Anguilla Antigua and Barbuda Argentina Armenia Aruba Ascension Island Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bhutan Bolivia Botswana Bosnia and Herzegovina Brazil Brunei Bulgaria Burkina Faso Burma Burundi Cambodia Cameroon Canada Chad Cape Verde Cayman Islands Central African Republic Chili China Christmas Island Cocos (Keeling)Islands Colombia Comoros Congo, Democratic Republic of Congo, Republic of Cook Islands Costa Rica Côte d'Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Finland Fiji France French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea - North Korea - South Kosovo Kuwait Kyrgyz Republic Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Nagorno-Karabakh Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Cyprus Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philipines Pitcairn Islands Poland Portugal Pridnestrovie Puerto Rico Qatar Romania Russia Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Pierre and Miquelon Vietnam Saint Vincent and the Grenadines Samoa San Marino São Tomé Saudi Arabia Senegal Serbia Sierra Leone Seychelles Singapore Slovakia Slovenia Solomon Islands Somalia Somaliland South Africa South Korea South Ossetia Spain Sri Lanka Sudan Suriname Svalbard Swaziland Sweden Switzerland Syria Tajikistan Tanzania Taiwan Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tristan da Cunha Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam British Virgin Islands United States Virgin Islands Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Not Listed in website
Payment Info
Credit Card Info	Mastercard Visa
Card no.*
Name on card*
Card Expires*	-- 01 02 03 04 05 06 07 08 09 10 11 12   -- 2016 2017 2018 2019 2020 2021 2022
Card Security No.*	What's this?
Comments
	I accept the purchase conditions* (Read)
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Note: Express shipping for national mailing only. Your kit will be posted on the same day for payments received by 12pm. Please send an email to dna@dnasolutions.co.uk if you wish to make your payment by bank transfer.

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** Please note that if the kit is to be mailed overseas, an additional fee of 5€ will apply.