PEPTIDE SYNTHESIS ORDER FORM
PEPTIDE SYNTHESIS ORDER FORM
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SHIPPING INFORMATION |
BILLING INFORMATION |
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Name: ___________________________ Address: _________________________ _________________________________ _________________________________ Phone: _______________ Fax: _________________
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Name: ___________________________ Address: _________________________ _________________________________ _________________________________ Phone: __________________ Fax: ____________________ P.O. #: __________________ |
STRUCTURE OF PEPTIDE (N -> C; INDICATE DISULFIDE BONDS):
Chemistry Desired: ______FMOC  _____TBOCC-Terminus: ______AMIDE
_____COOHN-Terminus: ______NH3+
______ACETYL ______SUCCINYL______OTHER (e.g.,
benzoyl, aminobenzoyl, etc.)Specify: ___________________________________________________ Desired Quantity: _____mgs; _____g;
_____ µmolDesired Purity: _____CRUDE (70-85%) _____
>95% _____>98%Mass Spec. Required: _____ Yes
_____NoOther Information/Requirements: ________________________________________________________________________ ________________________________________________________________________ |