Genetic Testing The Funding ProcessCollect DocumentationSubmit Application Genetic Testing Application 1Applicant2Spouse & Declaration CommentsThis field is for validation purposes and should be left unchanged.Terms & DocumentsTerms & Conditions(Required) I accept the Terms & Conditions and have prepared the financial documentation. Financial Details Spreadsheet & Supporting Documents(Required) Drop files here or Select files Accepted file types: pdf, xls, xlsx, jpg, jpeg, png, Max. file size: 10 MB, Max. files: 6. Who is applying?(Required) Just me Me and my spouse Applicant DetailsYour Name(Required)Cell Phone(Required)Email(Required) Date of Birth(Required) DD slash MM slash YYYY Your Hebrew Name(Required)Were you born Jewish?(Required) Yes No Where were you converted? (Rabbinical court)(Required)Conversion date(Required) DD slash MM slash YYYY Do you belong to a Medical Aid?(Required) Yes No Medical Aid provider(Required)Medical Aid plan(Required)Have you had genetic testing before?(Required) Yes No Spouse's DetailsSpouse's Name(Required)Spouse's Cell Phone(Required)Spouse's Email(Required) Spouse's Date of Birth(Required) DD slash MM slash YYYY Spouse's Hebrew Name(Required)Was your spouse born Jewish?(Required) Yes No Spouse — Where were they converted? (Rabbinical court)(Required)Spouse — Conversion date(Required) DD slash MM slash YYYY Does your spouse belong to a Medical Aid?(Required) Yes No Spouse — Medical Aid provider(Required)Spouse — Medical Aid plan(Required)Has your spouse had genetic testing before?(Required) Yes No DeclarationAnything else you would like us to know?Declaration of Accuracy(Required) I declare that the information provided is accurate and complete to the best of my knowledge. Privacy & POPIA Consent(Required) I have read the Privacy Policy and consent to Malka Ella processing the personal information in this application. Malka Ella collects this information solely to assess and administer your application. See our Privacy Policy for how we handle, store and retain your personal information.
