Please complete the application below and hit the submit button. Your application will be reviewed and upon acceptance added to the listserv within 24 hours of receipt.
The information given below is to qualify individuals for participation in the listserv. This information will never be released or sold to any individual or company. It is needed to insure only individuals who have experienced infertility and are pursuing embryo donation are admitted into this online support group. Thank-you.
1) Name
2)Email address to be used for the listserv Please enter full address carefully.
3) Address(Optional)
4) Age 25-30 31-35 36-40 41-45 46-50 50+
5) Have you had infertility problems for longer than 1 year? Yes No
6) If yes, please discuss them.
7) Have you had any pregnancies? Yes No
8) If yes, how many went to term?
9) How many children do you have, if any?
10) What are your children's ages?
11) Would you want to participate in a "Embryo Adoption Surrogacy Dial Us" phone directory? Yes No
If yes, please add your phone number
12.) Please let us know how the Listserv and On-Line Support Group can help you by telling us below:
13.)I have read the Rules of Conduct and agree to abide by them to retain my privilege to participate in this online support group. I understand if I violate any of these rules, I may be unsubscribed, without warning, to protect the best interest of the group. Yes No
14.)This email discussion list is currently averaging approximately 10-15 emails per day. You may choose how you would like to receive the messages: Individual emails as they are generated by the members. DAYDIGEST - One email per day which is a digest of all the messages posted in a 24 hour time period.
Copyright 2000. TASC: The American Surrogacy Center, Inc., Kennesaw, GA
The information contained in the website may not be published, broadcast, rewritten or otherwise distributed without the prior written authority of The American Surrogacy Center, Inc. If you would like to include this information on your website, you may link to the page directly on our site.
Guest commentary and representations by others do not necessarily reflect the opinions of the principals of TASC, and should furthermore be independently verified.
