Nucleic Acid Sequencing Order Form

NUCLEIC ACID SEQUENCING ORDER FORM

TYPE OF SEQUENCING DESIRED:

_____ ECONO-SEQUENCING
_____ COMPREHENSIVE SEQUENCING

In a continuing effort to provide better data, we ask that you complete this order form for all sequencing orders. Please indicate the template name, whether it is a PCR product, plasmid, etc., the size of the insert or PCR product, the concentration of the template (if lyophilized, the amount lyophilized), the standard primer to use, or the concentration and sequence of primers if you are supplying them. Please attach a picture of a gel of your templates with an appropriate size standard (page two), and list any special instructions or other information necessary for your project.

	TEMPLATE				PRIMER
	NAME	TYPE	SIZE	CONCENTRATION	NAME	CONCENTRATION
1
2
3
4
5
6
7
8
9
10
11
12

PRIMER SEQUENCE

	NAME	CONCENTRATION	SEQUENCE
Primer 1
primer 2
Primer 3
Primer 4
Primer 5
Primer 6
Primer 7
Primer 8

Please include Photograph of the templates on a gel including appropriate marker and indicate the quantity of template loaded:

	Sample:	Amount Loaded:
	Lane 1
	Lane 2
	Lane 3
	Lane 4
	Lane 5
	Lane 6
	Lane 7
	Lane 8
	Lane 9
	Lane 10

SHIP TO:

Name : ____________________________

Address: __________________________

_________________________________

Phone: ________________

Fax: __________________

Email: ______________________________

BILL TO:

Name : ______________________________

Address: ____________________________

___________________________________

Phone: ___________________

Fax: _____________________

PO #: ____________________

For CBI Preparation of template and special products:

Plasmid and/or phage vector
Insert sight
Host
Antibiotic resistance
Phage titer
How sample is supplied
Storage conditions

Any special instructions:

______________________________________________________________________________________