Type of Investor:

Other:

Agriculture

Gene therapy

Antibodies

Genotyping

Bioinformatics

Industrial enzymes

Biomass/biomaterials

Metabolomics

Biopharmaceuticals

Microarrays

Diagnostics

Nutrition

Drug discovery

Proteomics

Environmental/remediation

Signal transduction

Enzyme replacement

Small molecule

Gene expression arrays

      pharmaceuticals

Genomics

SNP analysis

Other:

Services Desired:

Raising capital

Management consulting

Legal services

Marketing research

Intellectual property

Financial analysis

      Development

Technology assessment

Strategic planning

Due diligence

Other:

Yes, I am an "Accredited Investor" as defined below (check each Accredited Investor category upon which such Subscriber qualifies).

No, I am not an "Accredited Investor" as defined below.

a natural person whose net worth, either individually or jointly with such person's spouse, at the time of purchase, exceeds $1,000,000;

a natural person who had an individual income in excess of $200,000 in each of the two (2) most recent years or joint income with that person's spouse in excess of $300,000, in each of those years, and reasonably expects to reach the same income level in the current year;

a bank as defined in Section 3(a)(2) of the Securities Act, or any savings and loan association or other institution as defined in Section 3(a)(5)(A) of the Securities Act, whether acting in its individual or fiduciary capacity;

a broker or dealer registered pursuant to Section 15 of the Securities Exchange Act of 1934, as amended;

an insurance company as defined in Section 2(13) of the Securities Act;

an investment company registered under the Investment Company Act of 1940 or a business development company as defined in Section 2(a)(48) of that Act;

a Small Business Investment Company licensed by the U.S. Small Business Administration under Section 301(c) or (d) of the Small Business Investment Act of 1958;

a plan established and maintained by a state, its political subdivisions, or any agency or instrumentality of a state or its political subdivisions, for the benefit of its employees, if such plan has total assets in excess of $5,000,000;

an employee benefit plan within the meaning of the Employee Retirement Income Security Act of 1974, if the investment decision is made by a plan fiduciary, as defined in Section 3(21) of such act, which is either a bank, savings and loan association, insurance company, or registered investment adviser, or if the employee benefit plan has total assets in excess of $5,000,000 or, if a self-directed plan, with investment decisions made solely by persons that are Accredited Investors;

a private business development company as defined in Section 202(a)(22) of the Investment Advisers Act of 1940, as amended;

an organization described in Section 501(c)(3) of the Internal Revenue Code, corporation, business trust, or partnership, not formed for the specific purpose of acquiring the relevant shares, with total assets in excess of $5,000,000;

a director or executive officer of the Company;

a trust, with total assets in excess of $5,000,000, not formed for the specific purpose of acquiring the relevant shares, whose purchase is directed by a sophisticated person who has such knowledge and experience in financial and business matters that such person is capable of evaluating the merits and risks of investing in the Company; or

an entity in which all of the equity owners qualify under any of the above subparagraphs.