Download - Mouse Biology Program

Murine Genetics Analysis Laboratory (MGAL)
Mouse Biology Program
University of California, Davis
2795 Second Street, Suite 400 Davis, CA, 95618
Tel: 530-757-3333 Fax: 530-757-3277
E-mail: [email protected]
Genotyping Request Form
Date:
Customer:
Email:
Service
U.C. Recharge
Non-Profit Rate
Standard PCR Development:
$447.00
$645.46 per sample
Protocol Incorporation:
$80.00
$115.52
Standard PCR:
$12.00 Per Sample
$18.00 Per Sample
QPCR Development:
$436.00 Per Probe
$629.58 Per Probe
QPCR Single Reaction:
$9.00 Per Sample
$12.99 Per Sample
QPCR Double Reaction:
$10.00 Per Sample
$14.44 Per Sample
Strain Information
Strain Name:
Genetic Background of Strain:
(E.g.: C57BL/6J; BALB/cJ; 129X1/Svj; FVB/
NJ; etc.)
MMRRC# / KOMP
allele (if applicable):
An Order Processing fee will apply.
If targeted mutant, ES
cell line identification:
* Please see sample submission instructions on page three.
Single Nucleotide Polymorphism (SNP) Testing
Service
U.C. Recharge
Single Nucleotide Polymorphism (SNP) : $140.00 Per Sample
MBP#
Backcross Generation:
Non-Profit Rate
Donor Strain:
$202.16 Per Sample
An Order Processing fee will apply.
Recipient Strain:
* Please see sample submission instructions on page three.
Is the mutation X-linked?
Genotyping Request
Genotyping Protocol provided ?
Yes
Yes
No
No
Sample notes,
or comments:
How many samples will you be sending?
Sample ID
Sex
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Parental Genotype(s)
Not known
Contact Information
Contact First Name:
Contact Last Name:
Contact Tel Number:
Contact Fax Number:
Contact E-mail:
PI First Name:
PI Last Name:
PI Tel Number:
PI Fax Number:
PI E-mail:
Institution:
School:
Address:
City:
UCD Cancer Center Member?
State/Province
Zip/Postal Code:
Primary contact for results
Billing Information
Billing Contact First Name:
Billing Contact Last Name:
Tel Number:
Billing Address:
Fax:
E-mail:
State/Province
City:
Zip/Postal Code:
Payment Information
All international investigators are required to prepay by either wire transfer, credit card or check.
Credit Card, Wire Transfer or Check Payments:
Check
Please, make all checks payable to: The Regents of U.C.
You will receive an MBP-Project # to reference upon project initiation.
Remit Address: The Regents of U.C.
Cashier's Office
University of California, Davis
P.O. Box 989602
West Sacramento, CA 95798-9062
For those wishing to pay by credit card or wire transfer please indicate your preference below and we will send you instructions.
Credit Card
Wire Transfer
Non-University of California U.S. Investigators May Pay by Purchase Order:
PO's should be made out to: University of California, Davis:
Purchase Order: (Non-UC Customers Only)
Company Name:
Mouse Biology Program
University of California, Davis
Mailing Address:
UCD MBP Facility
2795 2nd Street, #400
Davis, CA 95618
Please fax a copy of the PO to:
Attn: Concierge Service
530-757-3277
Or Email to mbpservice.ucdavis.edu
A completed W9 form can be found at:
http://accounting.ucdavis.edu/Forms/TA_W9.pdf
You will receive an MBP-Project # to reference upon project initiation.
University of California Investigator Payment Information:
Campus Recharge (UCD only): Chart Code:
Intercampus String (other UC campuses):
Account Number:
Please complete and return the provided intercampus billing form.
*The UC Davis Mouse Biology Program is a non-profit institution*
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Submission Instructions
• To fill out request form completely. Request will not be processed if you don't provide valid payment info: UCD Campus
Recharge number, UC Intercampus Recharge number, or Purchase Order (Non-UC Only). If you prefer to use a Credit Card
or Wire Transfer, please contact the MBP Concierge Service ([email protected]) and we will create the links for you.
Please DO NOT send your credit card info with this request.
• To provide 2-5 mm tail snip, or an ear punch, or a toe for analysis. If submitting DNA for analysis, for best results, please
provide 20ul-200ul high quality DNA (i.e. Qiagen prep). Please include concentration for each sample.
• For Speed Congenics, to provide DNA from Qiagen DNeasy kit or similar column based kit.
• To ship tissues on dry ice by overnight service to: MGAL, Mouse Biology Program, University of California, Suite 400,
2795 Second Street, Davis, California 95618, USA. Please send the Tracking Number to [email protected]
after the shipment is picked up.
• To provide sequence file of the transgene or targeting vector for protocol development by MBP. If supplying an existing
working protocol (Taqman or PCR), please include: Primer sequences, Reagents/Kit, Thermal cycling conditions, DNA
extraction method previously used.
MBP Description of Services:
• To provide accurate data and reports.
• Standard Genotyping results will be provided in 5-7 working days when protocol is in place.
• SNP results are normally provided 3-4 weeks after samples are received.
*The UC Davis Mouse Biology Program is a non-profit institution*
The University of California, Davis, Mouse Biology Program (MBP) is a coordinated, campus-supported teaching, research, and service resource of
infrastructure and fundamental expertise directed at developing, promoting, and enhancing the use of mouse model systems for understanding and
resolving biological problems.
Please be sure to acknowledge the Mouse Biology Program (MBP) in your publications.
For more information on how to acknowledge the MBP, please visit the Acknowledgement page on the MBP web site.
Please provide us with PDF copies of any publications in which the MBP is acknowledged; these may be emailed to
[email protected]. Additionally, please notify us of any grant applications in which the MBP is listed as a resource, both when
they are submitted and when they are funded.
Please fax a copy of request form to MBP at 530-757-3277, or e-mail to [email protected]
Thank You!
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