ONLINE DNA PROBE ARRAY / GENECHIP SAMPLE-SHEET

| BEMF | CRCH | JABSOM | PBRC | UHM |

ONLINE DNA PROBE ARRAY / GENECHIP SAMPLE-SHEET

GENOMICS
DNA Sequencing
Genotyping / GeneScan
Real-Time PCR
Oligo Synthesis
GeneChip Probe Array
Custom Spotted Array

PROTEOMICS
Protein Sequencing
Mass Spectrometry

BIOINFORMATICS
GCG / SeqWeb
Molecular Modeling
Internet Resources

You can move from field to field by pressing the TAB key.
Use the ENTER key to submit the form only.

Contact Information

PI Name
Order Placed By
PO/Requisition Number
Institution
Department
Telephone
FAX
E-mail

Billing Address

Name
Institution
Department
Building/Room
Street Address
City, State/Country
Zip Code

Shipping Address:
(Complete only if you are located off campus and your results are to be mailed to you.)

Name
Institution
Department
Building/Room
Street Address
City, State/Country
Zip Code

Investigators are responsible for ordering their Affymetrix chips. You can bring them to the Facility when submitting samples Users should provide purified cDNA or RNA. For best results, use either 2-5 µg polyA+mRNA or 20-50 µg total RNA as starting material in your cDNA synthesis or bring the same amount of RNA to the Facility for processing

Starting Material

Total RNA

PolyA+ mRNA

cDNA

1. Sample Name
Affymetrix GeneChip Type
ug of Starting Material
2. Sample Name
Affymetrix GeneChip Type
ug of Starting Material
3. Sample Name
Affymetrix GeneChip Type
ug of Starting Material
4. Sample Name
Affymetrix GeneChip Type
ug of Starting Material
5. Sample Name
Affymetrix GeneChip Type
ug of Starting Material

Special Indstructions
Type Of Computer	MAC	PC
Data Delivery	CD-R/CD-RW	Zip
	DAT file	XLS file
	Report file	Image file

CERTIFICATION I CERTIFY THAT THIS WORK-ORDER IS IN ACCORDANCE WITH APPLICABLE UNIVERSITY POLICIES AND PROCEDURES.
NO YES