Reagent Request Form
Reagent Request Form
Please use this form to electronically submit your requests.
Reagent type
*
Reagent type
Strain
Antibody
Plasmid
Other
Name
Name
*
First
Last
E-Mail (must be valid)
*
Lab Affiliation
Address
Phone
Phone
*
-
###
-
###
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Fax (if available)
Reagent Name(s)
*
Remarks
Federal Express Account Number
(If you wish to provide a Federal Express account number, we will send your reagents Federal Express. Otherwise, your shipment will be sent by US mail. Thank you.)