POLYCLONAL ANTIBODY PREPARATION

SHIPPING INFORMATION

BILLING INFORMATION

Name: ___________________________

Address: _________________________

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Phone: _______________

Fax: _________________

 

Name: ___________________________

Address: _________________________

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ANTIGEN INFORMATION
Antigen Name (or designation):

 Antigen State: Liquid / Dry / Gel (Circle one)
CBI to prepare?* Yes / No (circle one) Antigen Storage? 4° C -20° C
Peptide / Map / Protein / Other: Antigen Mol. Wt.:
Amount: ________ mg Concentration: ______________ mg/ml
Volume: ________ mL Buffer: ELISA Titration Services: Yes / No
Is antigen conjugated? Yes / No
Conjugated to: KLH / BSA / Other:

 Conjugation Services: Yes / No
Purification Services: Yes / No Free: Cysteine / Carboxyl grp / Amino grp
Purification Protocol (circle one):
Affinity Purification / Protein A / (NH4)2 SO4 / DEAE / Other:		 Bio Hazard Concerns:


Special Instructions:
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* Please complete Peptide Synthesis Order Form or provide a copy of CBI's specific quotation for preparation of your immunogen.