Research Orders form

EBRC Research Orders

Today's Date(Required)
Name of Principal Investigator(Required)
Name of individual submitting the order(Required)
Kindly choose the institution from which you would like to place an order.(Required)

Order details

Order details
Vendor name
Product of catalog name
Catalog number
Quantity
Unit of measure
Per unit price
Total cost
 
Please list vendors alphabetically.
Primer details
Vendor name
Oligo Name
Oligo Sequence
Synthesis Scale (25 or 50 nmole)
Comments
 
Dry Ice
Vendor name
Units (lbs.)
Quantity
Delivery Date
 
Funding source(Required)
Description
Cost Center or Internal Number
Provider (PI's Name)
Funding Source| Project #
Comments
 
Drop files here or
Max. file size: 100 MB.
    **Please make sure the quote mirrors the ordering detail section. **