Transgenic Research Center In the Cancer Center

Service Requisition Form

DNA Microinjection for Transgenic Mice


Which service?

Contact Data:


Date: Name:
Dept: PI:
Lab location    


Billing Account Information:

Project#  (eg, 1234567)
Task# (eg, 100)
Award (rg, ACAEH)

NCI Funded? 
Name of person who has authorization to the account: 

Is it okay if we include your mice in our mouse database?  

A-PLAC protocol #:  
Animal Housing Location:   
Construct Name (12 character limit):   


Length  kb Concentration  ng/ul
Volume  ul Purification method (CsCl, Qiagen,or others) 


Project and DNA Construct Description (attach restriction map):


Special Requirements (including special requirements for strian background):


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