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Please
complete the application below and click submit. Your application will be
reviewed and, upon acceptance, added to the list within 24 hours of receipt.
The information given below qualifies individuals for participation in the
mailing list. This information will never be released or sold to any
individual or company. It is needed to ensure that only
individuals who qualifyare admitted to this online support
group. Thank you.
BEFORE YOU SUBMIT Please recheck your e-mail address to ensure
it is accurate. If we do not receive the correct e-mail address, it will be
impossible for us to contact you to let you know that the server cannot reach
you.
We do NOT reject applications without contacting the applicant to discuss
why they are being rejected. So if you do not hear from Fortility within 48
hours, you can assume there is some problem with your e-mail address. Either
re-submit or contact the moderators directly.
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| Name
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| First
Last
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| Email
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(confirm
email)
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| Create the password that you want to use to access the list
Archives and Account Management website.
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| Your Location:
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City
State/Province
Country
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| Age
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| Have you achieved a successful pregnancy and live birth through
donor egg, donor sperm and/or surrogacy?
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| If so, what ART method(s) did you use? |
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| How many children do you have through ART and what are their
ages? |
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| If this was not your first child(ren), please tell us the ages
of other children and how they came into your life: routine pregnancy, adoption
etc. |
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Have you or do you plan to tell your children, family, friends
about the use of ART?
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| If yes, please discuss. |
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| Please let us know how the On-Line Support Group can help
you:
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| You may choose how you would like to receive the list messages.
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| How did you hear about us?
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Rules of Conduct to
retain my privilege to participate in this online support group. I understand
that if I violate any of these rules, I may be unsubscribed, without warning,
to protect the best interest of the group. |
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