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Exhibit 10.1
 
SUBSCRIPTION AGREEMENT

Applied DNA Sciences, Inc.
25 Health Sciences Drive, Suite 113
Stony Brook,  New York 11790

Gentlemen and Ladies:

The undersigned (the “Subscriber”) hereby subscribes for a $_______________
principal amount senior secured convertible promissory note (“Note”) of Applied
DNA Sciences, Inc., a Delaware corporation (the “Company”).  The Note is in the
form attached hereto as Annex 1.
 
1.  Subscription. Subject to the terms and conditions hereof, the Subscriber
agrees to pay $_______________ by check or wire transfer of immediately
available funds as consideration for the Subscriber’s Note.  The Subscriber
tenders herewith a check made payable at the direction of the Company or wire
transfer, in the amount of $_______________.  The Subscriber acknowledges and
agrees that this subscription is irrevocable by the Subscriber but is subject to
acceptance by the Company.  The Subscriber understands and agrees that a
placement fee of up to 15% of the proceeds of this subscription may be paid, and
warrants to purchase 5% of the New Notes may be issued, to one or more placement
agents in connection with this subscription.

2.  Subscription Compliance.  The Subscriber agrees that this subscription is
subject to the following terms and conditions:

The Company shall have the right, in its sole discretion, to: (i) accept or
reject this subscription; (ii) determine whether this Subscription Agreement has
been properly completed by the Subscriber and (iii) determine whether the
Subscriber has met all of the Company’s requirements for investment in the
Note.  If the Company deems this subscription to be defective, deficient or
otherwise non-compliant with the terms of this offering, the Subscriber’s funds
will be returned promptly to the Subscriber without interest or deduction.

3.  Receipt of Information.

a.  
The Subscriber and Subscriber’s purchaser representative, if any, have received
a copy of the Company’s most recent Annual Report on Form 10-K, Quarterly
Reports on Form 10-Q and current reports on Form 8-K, if any.  The Subscriber,
either alone or together with Subscriber’s purchaser representative, if any,
have such knowledge and experience in financial and business matters as to be
able to evaluate the merits and risks of an investment in the Company.

b.  
The Subscriber and Subscriber’s representative, if any, have had the opportunity
to ask questions of and receive answers from the Company concerning the terms
and conditions of the offering of the Note by the Company and to obtain any
additional information Subscriber has requested which is necessary to verify the
accuracy of the information furnished to the Subscriber concerning the Company
and such offering.

4.  Representations of Subscriber. In connection with the purchase of the Note,
the Subscriber hereby represents and warrants to the Company as follows:

a.  
The Subscriber is an “accredited investor” as defined in Rule 501 of Regulation
D promulgated under the Act.

 
 
 

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b.  
The Note is being purchased for the Subscriber’s own account without the
participation of any other person, with the intent of holding the Note for
investment and without the intent of participating, directly or indirectly, in a
distribution of the Note and not with a view to, or for a resale in connection
with, any distribution of the Note or any portion thereof, nor is the
undersigned aware of the existence of any distribution of the Company’s
securities.  Furthermore, the undersigned has no present intention of dividing
such Note with others or reselling or otherwise disposing of any portion of such
Note, either currently or after the passage of a fixed or determinable period of
time, or upon the occurrence or nonoccurrence of any predetermined event or
circumstance.

c.  
The Subscriber has no need for liquidity with respect to his purchase of a Note
and is able to bear the economic risk of an investment in the Note for an
indefinite period of time and is further able to afford a complete loss of such
investment.

d.  
The Subscriber represents that his financial commitment to all investments
(including his investment in the Company) is reasonable relative to his net
worth and liquid net worth.

e.  
The Subscriber recognizes that the Note will be sold to the Subscriber without
registration under any United States federal or other law relating to the
registration of securities for sale.

f.  
The Subscriber is aware that any resale of the Note cannot be made except in
accordance with the registration requirements of the United States Securities
Act of 1933, as amended (the “Securities Act”) or an exemption therefrom.

g.  
The Subscriber represents and warrants that all offers and sales of the Note
shall be made pursuant to an exemption from registration under the Act or
pursuant to registration under the Act, and the Subscriber will not engage in
any hedging or short selling transactions with regard to the Note or the
underlying common stock.

h.  
The Subscriber is not acquiring the Note based upon any representation, oral or
written, by any person with respect to the future value of, or income from, the
Note but rather upon an independent examination and judgment as to the prospects
of the Company.

i.  
The Subscriber understands that the Company is an early stage company, has
limited operating funds and has a limited operating history.  The Subscriber
appreciates and understands the risks involved with investing in a Company with
a limited operating history and has read and understands the risk factors and
other information set forth in the Company’s Annual Report on Form 10-K, filed
on December 23, 2009, and the Company’s Quarterly Reports on Form 10-Q, filed on
February 11, 2010 and August 13, 2010.  These reports and any future filings
made with the SEC under Section 15(d) of the Securities Exchange Act of 1934, as
amended, can be obtained by visiting the Securities and Exchange Commission’s
website at http://www.sec.gov.  The Subscriber is not relying on any other
written information which may have been provided by the Company or the Company’s
placement agent.

j.  
The Subscriber represents, warrants and agrees that it will not sell or
otherwise transfer the Note without registration under the Securities Act or an
exemption therefrom, and fully understands and agrees that the Subscriber must
bear the economic risk of its purchase because, among other reasons, the Note
has not been registered under the Securities Act or under the securities laws of
any state and, therefore, cannot be resold, pledged, assigned or otherwise
disposed of unless they are subsequently registered under the Securities Act and
under the applicable securities laws of such states, or an exemption from such
registration is available.  In particular, the Subscriber is aware that the Note
is a “restricted security,” as such term is defined in Rule 144 promulgated
under the Securities Act (“Rule 144”), and it may not be sold pursuant to Rule
144 unless all of the conditions of Rule 144 are met.

 
 
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k.  
The Company, by and through itself and/or legal counsel, has made no
representations or warranties as to the suitability of the Subscriber’s
investment in the Company, the length of time the undersigned will be required
to own the Note, or the profit to be realized, if any, as a result of investment
in the Company.  Neither the Company nor its counsel has made an independent
investigation on behalf of the Subscriber, nor has the Company, by and through
itself and counsel, acted in any advisory capacity to the Subscriber.

l.  
The Company, by and through itself and/or legal counsel, has made no
representations or warranties that the past performance or experience on the
part of the Company, or any partner or affiliate, their partners, salesmen,
associates, agents, or employees or of any other person, will in any way
indicate the predicted results of the ownership of the Note.

m.  
The Company has made available for inspection by the undersigned, and his
purchaser representative, if any, the books and records of the Company. Upon
reasonable notice, such books and records will continue to be made available for
inspection by investors upon reasonable notice during normal business hours at
the principal place of business of the Company.

n.  
The Note was not offered to the Subscriber by means of publicly disseminated
advertisement or sales literature, nor is the Subscriber aware of any offers
made to other persons by such means.

o.  
All information which the Subscriber has provided to the Company concerning the
Subscriber is correct and complete as of the date set forth at the end of this
Subscription Agreement, and if there should be any material adverse change in
such information prior to receiving notification that this subscription has been
accepted, the undersigned will immediately provide the Company with such
information.

5.  Agreements of Subscriber.  The Subscriber agrees as follows:

a.  
The sale of the Note by the Company has not been recommended by any United
States federal or other securities commission or regulatory authority.
Furthermore, the foregoing authorities have not confirmed the accuracy or
determined the adequacy of this Subscription Agreement.

b.  
The Note and the underlying common stock will not be offered for sale, sold, or
transferred other than pursuant to: (i) an effective registration under the Act
or in a transaction otherwise in compliance with the Act; and (ii) evidence
satisfactory to the Company of compliance with the applicable securities laws of
other jurisdictions. The Company shall be entitled to rely upon an opinion of
counsel satisfactory to it with respect to compliance with the above laws.

 
 
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c.  
The Company is under no obligation to register the Note or to comply with any
exemption available for sale of the Note without registration, and the
information necessary to permit routine sales of securities of the Company under
Rule 144 of the Act may not be available when you desire to resell them pursuant
to Rule 144 of the Act. The Company is under no obligation to act in any manner
so as to make Rule 144 available with respect to the Note.

d.  
There is no established market for the Note and it is not anticipated that any
public market for the Note will develop in the future.

e.  
The Company may, if it so desires, refuse to permit the transfer of the Note
unless the request for transfer is accompanied by an opinion of counsel
acceptable to the Company to the effect that neither the sale nor the proposed
transfer will result in any violation of the Act or the applicable securities
laws of any other jurisdiction.

f.  
A legend indicating that the Note and the underlying common stock have not been
registered under such securities laws and referring to the restrictions and
transferability of the Note and the underlying common stock may be placed on the
certificates or instruments delivered to the Subscriber or any substitutes
thereof and any transfer agent of the Company may be instructed to require
compliance therewith.

6.  Closing.  The Subscriber understands and agrees that the Company intends to
issue the Note upon receipt by the Company of this Subscription Agreement,
together with the Subscriber’s funds and certain other documents to be delivered
to the Company by Subscriber.  The Subscriber further understands that there may
be conditions to closing this subscription which if not met may result in the
return of this subscription hereunder.

7.  Indemnification of the Company. The undersigned understands the meaning and
legal consequences of the representations and warranties contained herein, and
hereby agrees to indemnify and hold harmless, the Company, its respective
agents, officers, managers and affiliates from and against any and all damages,
losses, costs and expenses (including reasonable attorneys’ fees) which they or
any of them may incur by reason of the failure of the Subscriber to fulfill any
of the terms of this Subscription Agreement, or by reason of any breach of the
representations and warranties made by the Subscriber herein, or in any document
provided by the Subscriber to the Company.

8.  Representative Capacity. If an investment in the Company is being made by a
corporation, partnership, trust or estate, the undersigned individual signing on
behalf of the Subscriber, represents that he has all right and authority, in his
capacity as an officer, managing member, trustee, executor or other
representative of such corporation, trust or estate, as the case may be, to make
such decision to invest in the Company and to execute and deliver this
Subscription Agreement on behalf of such corporation, trust or estate as the
case may be, enforceable in accordance with its terms. The undersigned
individual also represent that any such corporation, trust or estate was not
formed for the purpose of buying the Note hereby subscribed.

9.  Subscription Not Revocable. The undersigned hereby acknowledges and agrees
that the undersigned is not entitled to cancel, terminate or revoke this
Subscription Agreement or any agreements of the undersigned hereunder and that
this Subscription Agreement shall survive the dissolution, death or disability
of the undersigned.
 
 
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10.  Restrictions on Transferability. The undersigned understands and agrees
that the Note shall not be sold, pledged, hypothecated or otherwise transferred
unless the Note is registered under the Act and applicable state securities laws
or an exemption from such registration is available.

11.  Governing Law. This Subscription Agreement is being delivered and is
intended to be performed in the State of New York, and shall be construed and
enforced in accordance with, and the law of such state shall govern the rights
of parties.

12.  Numbers and Gender. In this Agreement, the masculine gender includes the
feminine gender and the neuter and the singular includes the plural, where
appropriate to the context.

 
THIS SPACE INTENTIONALLY LEFT BLANK; QUESTIONNAIRE FOLLOWS
 
 
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Exhibit 10.1
 
CONFIDENTIAL PROSPECTIVE PURCHASER QUESTIONNAIRE

This questionnaire is to be completed by each accredited investor (“Accredited
Investor”) as defined in Rule 501 promulgated under the United States Securities
Act of 1933, as amended (the “Securities Act”) who desires to purchase from
Applied DNA Sciences, Inc., a Delaware corporation (the “Company”), a senior
secured convertible promissory note (“Note”).

INSTRUCTIONS

This Questionnaire is being given to the person who has expressed an interest in
purchasing Notes of the Company.  The purpose of this Questionnaire is to
determine whether you meet certain standards, because the Securities to be
offered by the Company have not been, and will not be, registered under the
Securities Act.

If the answer to any questions is “None” or “Not Applicable,” please so state.

Your answers will be kept confidential at all times, however, you hereby agree
that the Company may present this Questionnaire to such parties as it deems
appropriate in order to assure itself that the offer and sale of Securities to
you will not result in violations of federal or state securities laws which are
being relied upon by the Company in connection with the offer and sale thereof.

INSTRUCTIONS:  Please type or clearly print your answer, and state “none” or
“not applicable” when appropriate.  Please complete Section A and each other
section you are requested to complete in Question A3.  If there is insufficient
space for any of your answers, please attach additional pages.  If the
Securities are to be owned by more than one individual or by a corporation or
partnership, you may need extra copies of this Questionnaire.  You may use
photocopies or request extra copies from the Company.

SECTION A:  SUBSCRIBER INFORMATION
 

A1.  Name(s) of Subscriber(s):                           A2.  Principal Amount
of Notes       Subscribed for: $                   A3.  Manner of Ownership of
Securities (please check below):         __  One Individual ........
Please complete Section A, B, C and, if applicable, D, E and F.
 

 
 
 

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__  Husband and Wife.......   Please have one spouse complete Sections A, B, C
and   Tenants by the Entirety   if applicable, D, E and F. Please have both
spouses complete Section C.         __  Tenants in Common.......   Please have
each individual separately complete Sections A, B, and C and if applicable, D, E
and F.         __  Joint Tenants with......    Please have each individual
separately complete Sections A, B, and C and if applicable, D, E and F.   Right
of Survivorship       Two or More Individuals       (but not husband and wife)  
          __  Corporate Ownership.....   Please complete Sections A, B, D and,
if applicable, E and F for the corporation.  Please have each person who owns an
equity interest in the  corporation separately  complete Sections B and, if
applicable, C, D, E and F.         __  Partnership Ownership...   Please
complete Sections A, B and D, and have each general partner and limited partner
separately complete Sections B, C, D, E and F, if applicable.         __  Trust
Ownership ........   Please complete Sections A, B and F, if applicable, and
have each beneficiary and trustee of the trust separately complete Sections B,
C, D, E and F, if applicable.

 
SECTION B:  ACCREDITED INVESTOR STATUS

B1.
Please check one or more of the following definitions of “accredited investor,”
if any, which applies to you.  If none of the following applies to you, please
leave a blank.

         (a)
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; any
broker or dealer registered pursuant to Section 15 of the Securities Exchange
Act of 1934 (the “Exchange Act”); 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; any plan established and maintained by a state,
or 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; any 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 advisor, 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.

         (b)
A Private Business Development Company as defined in Section 202(a)(22) of the
Investment Advisers Act of 1940.

 
 
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        (c)
An organization described in Section 501(c)(3) of the Internal Revenue Code or
corporation, Massachusetts or similar business trust, or partnership, not formed
for the specific purpose of acquiring the securities offered, with total assets
in excess of $5,000,000.

        (d)
A natural person whose individual net worth, or joint net worth with that
person’s spouse, at the time of purchase exceeds $1,000,000, excluding the value
of the person’s primary residence1.

        (e)
A natural person who had an individual income in excess of $200,000 in each of
the two most recent years or joint income with that person’s spouse in excess of
$300,000 in each of those years and has a reasonable expectation of reaching the
same income level in the current year.

        (f)
Any trust, with total assets in excess of $5,000,000, not formed for the
specific purpose of acquiring the Securities, whose purchase is directed by a
sophisticated person as described in Rule 506(b)(2)(ii) of Regulation D.

        (g)
Any entity in which all of the equity owners are Accredited Investors.

 
SECTION C:  INDIVIDUAL INFORMATION

C1.  General Information

Name:

Age:____Social Security Number (if applicable):

Marital Status:____Spouse’s Name:

If the Securities are to be owned by two or more individuals (not husband and
wife), are you related to any other co-owner(s)?

Yes___   No___

If yes, please explain the relationship(s):
 
 
 
 
 
 
 
 
 
 

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1           An investor need not deduct from his or her net worth the amount of
mortgage debt secured by an excluded primary residence, except to the extent
that the amount of the mortgage liability exceeds the fair value of the
residence.
 
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C2(a).  Principal Residence:
 

  Address:         Number         Street          
 City           State/Province              Country            Zip code        
Mailing Address (if other than Principal Residence above):    

           Number         Street                
 City           State/Province              Country            Zip code        
Telephone
Number: (     )                                                                                                          

 
C2(b).     Have you ever resided in the United States (including its territories
and possessions) or held a United States passport?

Yes___   No___

If yes, please explain where you lived, how long you lived there, or when you
held the passport:

 

C3.  Current Employment or Business Activity:           Company Name:     

 

          Address:          Number         Street  

 

            City                 State/Province                   
Country                          Zip code

 

  Telephone Number:     (    )             Principal Business:           

 

  Position and Title:         

 

  Description of Duties and Responsibilities:                

                  
Length of Time in Present
Position:                                                                                     

Is the company publicly owned?:  Yes ___ No __________________

C4.
Education:  Please describe your business and/or professional education or
training, listing any schools you have attended and degrees you have received.

 
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Dates   School Major    Degrees/
Year Receive

 
 
 
 
 
 
C5.
Prior Employment or Business Activity:  Please describe your prior employment or
principal business activities during the last five years, providing all
information requested below.

 
 

Dates  
Company Name
and Address
Principal
Business 
 Position
& Title   
Description of
Duties and
Responsibilities

 
                                                                                                  

 
 

 

 
C6.
The undersigned will provide a financial statement if requested by the Company.

C7.
Net worth, inclusive of the net worth of your spouse and inclusive of the value
of your principal residence, furnishings therein and personal automobiles):

 

  (  ) less than $100,000  (  ) $100,000 to $199,999   (  ) $200,000 to $499,999
(  ) $500,000 to $1,000,000   (  ) over $1,000,000  

 
C8.
Net worth:  Your net worth, inclusive of the net worth of your spouse and
excluding the value of your principal residence, furnishings therein and
personal automobiles:

 

  (  ) less than $100,000 (  ) $100,000 to $199,999   (  ) $200,000 to
$499,999   (  ) $500,000 to $1,000,000   (  ) over $1,000,000  

 
 
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C9.
Indicate (a) your individual income from all sources for the calendar years 2008
and 2009 and estimated income for 2010 or (b) your joint income with your spouse
from all sources for the calendar years 2008 and 2009 and estimated income for
2010:

(a)           individual income:
 

               
$ 60,000
$100,001
$200,000
$500,000
   
   to
   to
     to
  and
   
$100,000
$199,999
$499,999
  over       
           
2007
 
  (   )
 (   )  (   )   (   )             
2008
 
  (   )
 (   )
 (   )
  (   )            
2009
 
  (   )
 (   ) 
 (   )
  (   )

 

 
(b)
joint income:
             

 
 

               
$ 60,000
$100,001
$200,000
$500,000
   
   to
   to
     to
  and
   
$100,000
$199,999
$499,999
  over       
           
2007
 
  (   )
 (   )  (   )   (   )             
2008
 
  (   )
 (   )
 (   )
  (   )            
2009
 
  (   )
 (   ) 
 (   )
  (   )

 

C10.
(a)  Was some portion of your income during your last taxable year taxed at the
highest rate for income tax purposes?

______Yes                                ______No

 
(b)  Do you anticipate that some portion of your income during your current
taxable year will be taxed at the highest rate for income tax purposes?

______Yes                                ______No

C11.
Investment experience:

 
(a)
The frequency with which you invest in marketable securities is:

(   ) often                      (   ) occasionally                      (   )
never

 
(b)
The frequency with which you invest in unmarketable securities is:

(   ) often                      (   ) occasionally                      (   )
never

 
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SECTION D:  CORPORATE OFFEREES OR PARTNERSHIP OFFEREES

D1.
General Information

Legal Name of Corporation or Partnership:_________________________

____________________________________________________________

                Fictitious name:_______________________________________________

____________________________________________________________

 
Country of Incorporation:_____________________________________

Date of Incorporation:______________________________________
I.D. Number (if applicable):_______________________________________

Fiscal Year Ends:__________________________________________

Number of Equity Owners:____________________________________

Name and Title of Executive Officer Executing
Questionnaire:_____________________________________________

D2.           Business Address:__________________________________________

___________________________________________________________

Mailing Address (if different):___________________________

___________________________________________________________

                Telephone Number:            (___) ____________________________

 
Was the corporation or partnership formed for the specific purpose of purchasing
securities?

______Yes                      ______No

 
Check if applicable to the corporation:

Subchapter
S_________                                                                Professional_________

D3.           The undersigned represents and warrants as follows:

 
(a)
The corporation or partnership, as the case may be, has been duly incorporated
or formed (if a partnership), is validly existing as a corporation or
partnership in good standing under the laws of the jurisdiction of its
incorporation or formation with full power and authority to enter into the
transactions contemplated by the Subscription Agreement;

 
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(b)
          (i)  The officers or partners of the undersigned who, on behalf of the
undersigned, have considered the purchase of the Note and the advisers, if any,
of the corporation or the partnership, as the case may be, in connection with
such consideration are named below in this Questionnaire, and such officers and
advisors or partners, if any, were duly authorized to act for the corporation or
the partnership in reviewing such investment;

 
            (ii)  The names and positions of the officers or partners, of the
undersigned who, on its behalf, have reviewed the purchase of the Note are as
follows: 

______________________________________________________

______________________________________________________

 
              (iii)  In evaluating the merits and risks of the purchase of the
Note, the corporation or the partnership, as the case may be, intends to rely
upon the advice of, or will consult with, the following persons:

______________________________________________________

______________________________________________________

______________________________________________________

 
(c)
The officers of the corporation (if not Accredited Investors) or the partners of
the partnership who, on its behalf, have considered the purchase of the Note and
the advisors, if any, of the corporation or the partnership who, in connection
with such consideration, together have such knowledge and experience in
financial and business matters that such officer(s), partner(s) and such
advisor(s), if any, together are capable of evaluating the merits and risks of
the purchase of Note and of making an informed investment decision;

 
(d)
Together with any corporation or group of corporations with which it files a
consolidated federal income tax return, the undersigned has reserves and/or net
worth adequate to permit it to satisfy any tax or other liabilities arising from
its liability with respect to the investment and the operation thereof;

 
(e)
The net worth of the corporation or the partnership is in excess of
$__________________.

 
(f)
The corporation or the partnership has had, during each of the past two fiscal
or tax years, gross income from all sources of at least $__________________ and
$_____________________ respectively;

 
(g)
The undersigned expects the corporation or the partnership to have during the
current fiscal or tax year, gross income from all sources of at least
$_______________; and

 
(h)
The undersigned knows of no pending or threatened litigation the outcome of
which could adversely affect the answer to any question hereunder;

 
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(i)           Indicate the following if a partnership offeree:

(1)           The date the partnership was formed and state of
formation:_____________

(2)           The names of each partner in the partnership:

_________________________________________________

_________________________________________________

 
Please have each individual partner execute a separate Questionnaire.

Section E:            Trust Offerees

E1.           General Information:
Legal Name:________________________________________________

Country of Formation:________________________________________

Date of Formation:_________________________________________

I.D. Number:______________ Fiscal Year Ends:_______

Number of Beneficiaries:___________________________________

Principal Purpose:_________________________________________

 
Was the trust formed for the specific purpose of purchasing Securities?

______Yes                                ______No

 
Is any  trustee a United States person, as that term is defined in Rule 902(k)
promulgated under the Securities Act?

______Yes                                ______No

E2.           Business Address:__________________________________________

___________________________________________________________

Telephone Number:                  (___) _________________________________

Mailing Address:___________________________________________

___________________________________________________________

 
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E3.
Authorization:
If the trust was established in connection with a deferred compensation plan,
please attach a copy of the trust’s organizational documents and a properly
certified copy of the resolutions adopted by the trust’s board of directors
authorizing the trust to purchase the Note and authorizing the trustee named
below to execute on behalf of the trust all relevant documents necessary to
subscribe for and purchase the Note.  In all cases, please attach a properly
certified copy of the resolutions adopted by the trustees of the trust
authorizing the trust to purchase the Note and authorizing the trustee named
below to execute on behalf of the trust all relevant documents necessary to
subscribe for and purchase the Note.

Name of Authorized Trustee:___________________________

 
Section F:
Qualified Pension Plan (“Plan”) Offerees

F1.           Please initial the appropriate space below:

___________
a.

(initial)
                              The Plan requires the investment of each
beneficiary or participant to be held in a segregated account and the Plan
allows each beneficiary or participant to make his own investment decisions and,
the decision to purchase the Note has been made by the beneficiary or the
participant and such beneficiary or participant is an Accredited Investor
(Please have each such beneficiary or participant execute a separate
Questionnaire)

 OR

___________
b.

(initial)
The investment decisions made for the Plan are made by a plan fiduciary, whether
a bank, an insurance company, or a registered investment advisor.

 OR

___________                      c.
 (initial)
The Plan has total assets exceeding $5,000,000.

F2.           General Information:

Legal Name:________________________________________________

Country of Formation:________________________________________

Date of Formation:_________________________________________

I.D. Number:______________ Fiscal Year Ends:_______

Number of Beneficiaries:___________________________________

Principal Purpose:_________________________________________

 
10

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F3.           Business Address:__________________________________________

___________________________________________________________

Telephone Number:               (___) _________________________________

Mailing Address:___________________________________________

___________________________________________________________

F4.
Authorization:
If the investment decision is being made by a beneficiary or participant of a
Plan, please attach applicable trust documents which permit each beneficiary or
participant to make his own investment decisions.  In all other cases, please
attach a properly certified copy of the resolutions adopted by the trustees of
the Plan trust authorizing the Plan to purchase the Note and authorizing the
fiduciary named below to execute on behalf of the Plan all relevant documents
necessary to subscribe for and purchase the Note.

Name of Authorized Fiduciary:_________________________

F5.
Is any beneficiary or participant of a Plan a United States person, as that term
is defined in Rule 902(k) promulgated under the Securities Act?

______Yes                                ______No

THIS SPACE INTENTIONALLY LEFT BLANK; SIGNATURE PAGE FOLLOWS

 
11

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APPLIED DNA SCIENCES , INC.
SIGNATURE PAGE TO
QUESTIONNAIRE AND SUBSCRIPTION AGREEMENT

Your signature on this Signature Page evidences your agreement to be bound by
the Questionnaire and the Subscription Agreement.

The undersigned represents that (a) he/she has read and understands this
Subscription Agreement, (b) the information contained in this Questionnaire is
complete and accurate and (c) he/she will contact the Company immediately if any
material change in any of this information occurs before the acceptance of
his/her subscription and will promptly sent the Company written confirmation of
such change.

Subscriber hereby elects to subscribe under the Subscription Agreement for a
$_______________ principal amount senior secured convertible promissory note and
executes the Subscription Agreement.

IN WITNESS WHEREOF, the undersigned has executed this Questionnaire and
Subscription Agreement on the date set forth below.

Date of Execution: ______________, 2010

 
FOR INDIVIDUALS:
               
_____________________________
   
(Print Name)
       
Dated: ___________, 2010
_____________________________
 
 
(Signature)
         
FOR CORPORATIONS:
         
_____________________________
   
Name of Company
         
_____________________________
   
Executive Officer of Company
       
Dated: ___________, 2010
_____________________________
 
 
Signature of Officer
               
FOR PARTNERSHIPS:
               
_____________________________
   
Name of Partnership
               
_____________________________
   
Name of Partner executing
   
Questionnaire
 

 
 
12

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Dated: ___________, 2010
_____________________________
   
Signature of Partner
   
executing Questionnaire
         
FOR TRUSTS:
               
_____________________________
   
Name of Trust
         
_____________________________
   
Name of Authorized Trustee
   
Executing Questionnaire
       
Dated: ___________, 2010
_____________________________
   
Signature of Authorized
   
Trustee
         
FOR QUALIFIED PENSION PLANS:
               
_____________________________
   
Name of Qualified Pension Plan
         
                                   and
         
_____________________________
   
Name of Plan Fiduciary
   
executing Questionnaire
       
Dated: ___________, 2010
_____________________________
   
Signature of Plan Fiduciary
   
executing Questionnaire
         
                                   or
         
_____________________________
   
Name of Plan Beneficiary
   
executing Questionnaire
         
                                   or
 
Dated: ___________, 2010
_____________________________
 
 
Signature of Plan Beneficiary
   
executing Questionnaire
 

 
APPROVED THIS ____ DAY OF ______________, 2010

APPLIED DNA SCIENCES, INC.

By:________________________________                                                      
Name:
Title:
 
 
13

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Exhibit 10.1
 
ANNEX 1

Form of Note