GREENWOOD MOLECULAR BIOLOGY FACILITY

UNIVERSITY OF HAWAII AT MANOA

3050 Maile Way, Gilmore Hall 411, Honolulu, HI 96822

Phone: (808) 956-6718     Fax: (808) 956-9589     E-mail: biotech@hawaii.edu

GENESCAN / GENOTYPING FORM

PRIMARY INVESTIGATOR: _________________________________   DATE: _________________

YOUR NAME: ____________________________________________   DEPARTMENT: __________

ADDRESS:     _____________________________________________________________________

_____________________________________________________________________

PHONE: _______________   FAX:  ______________    E-MAIL: _____________________________

PURCHASE ORDER/REQUISITION NUMBER: __________________________________________

BILLING ADDRESS:  _______________________________________________________________

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Samples should be supplied as fluorescently labeled, pooled, PCR products. The concentration of product needs to be

optimized by the submitter prior to submission.  The facility will supply the internal size standard.  Two sets of dyes and size

standards are currently supported.  For most GeneScan applications, we recommend using the dye set for virtual filter set D.

Dye Set C:             6-FAM (blue)         6-HEX (yellow)     TET (green)          TAMRA (red, standard)

Dye set D:             6-FAM (blue),        NED (yellow)        6-HEX (green)      ROX (red, standard)

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Dye Set Used:     ____C     ____D

Dyes you have added to your samples:     ____Blue     ____Yellow     ____Green

      SAMPLE NAME:

  1. _______________     13. _______________     25. _______________     37. _______________

  2. _______________     14. _______________     26. _______________     38. _______________

  3. _______________     15. _______________     27. _______________     39. _______________

  4. _______________     16. _______________     28. _______________     40. _______________

  5. _______________     17. _______________     29. _______________     41. _______________

  6. _______________     18. _______________     30. _______________     42. _______________

  7. _______________     19. _______________     31. _______________     43. _______________

  8. _______________     20. _______________     32. _______________     44. _______________

  9. _______________     21. _______________     33. _______________     45. _______________

10. _______________     22. _______________     34. _______________     46. _______________

11. _______________     23. _______________     35. _______________     47. _______________

12. _______________     24. _______________     36. _______________     48. _______________

SPECIAL INSTRUCTIONS:  __________________________________________________________

DATA DELIVERY:

3.5’’ disk or ZIP disk (must provide) ______               FTP _______              E-mail attachment _______

Electrophoregram print-out ($2.00 per sample) _________

Type of Computer used:  MAC _______     PC _________

SIGNATURE:  ______________________________________ ___