Nucleic Acid Synthesis Order Information Sheet

NUCLEIC ACID SYNTHESIS ORDER INFORMATION SHEET

SHIPPING INFORMATION

BILLING INFORMATION

Name: ______________________________

Address: ____________________________

___________________________________

Phone: ___________________

Fax: _____________________

Email: ______________________________

Name: _____________________________

Address: ___________________________

___________________________________

Phone: ______________________

Fax: ________________________

P.O. #: ______________________

NAME __________________________________

SYNTHESIS:
DNA ___ RNA ___

SCALE:
50nM ___ 0.2 µM __ 1.0µ M ___

Other _____

TRITYL:
ON ___ OFF ___

PURITY: CRUDE ___ CARTRIDGE ___ HPLC ___ PAGE ___

5'_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _20

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _40

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3'

List any modifications required _______________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

NAME __________________________________

SYNTHESIS:
DNA ___ RNA ___

DNA SCALE:
50nM ___ 0.2 µM __ 1.0 µ ___

Other _____

TRITYL:
ON ___ OFF ___

PURITY: CRUDE ___ CARTRIDGE ___ HPLC ___ PAGE ___