Microarray Service Request Form Sample QC via nanodrop and bioanalyzer is performed as part of microarray processing. Complete ONLY this form if you would like the BUMSR Core to perform a microarray experiment for you. DO NOT complete the Bioanalyzer QC form in addition.HiddenDate MM slash DD slash YYYY ContactSubmitter Name(Required) First Last Submitter Email(Required) Submitter Telephone No.(Required)P. I. Name(Required) First Last P. I. Email(Required) Affiliation(Required)Boston UniversityExternal OrganizationDepartment(Required) Address(Required) Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code AccountingDo you have a BU Grant Account Number?(Required)Please email the MSR Core at MSRLab@bu.edu with your account number as soon as you are able to provide one. The service will not be provided until the Core receives the account number.YesNoUnsureDo you have an Invoice Number?(Required)Please email the MSR Core at MSRLab@bu.edu if you do not have an invoice number. The service will not be provided until the Core generates an invoice.YesNoUnsureGrant Administrator Name(Required) First Last Grant Administrator Email(Required) Microarray ProfilingNumber of Samples(Required) Sample Species(Required) Human Mouse Other QC Assay Type(Required) Human Gene 2.0ST Array Human Clariom S Array Human Clariom D Array Mouse Gene 2.0ST Array Mouse Clariom S Array Mouse Clariom D Array miRNA 4.0 Array Human Gene 1.0ST Array Human Genome U133A 2.0 Array Human Genome U133 Plus 2.0 Array Mouse Gene 1.0ST Array Mouse Genome 430A 2.0 Array Rat Gene 1.0ST Array Rat Gene 2.0ST Array Rat Transcriptome 1.0 Array Rat Genome 230 Array miRNA 2.0 Array miRNA 3.0 Array Arabidopsis Gene 1.0ST Array Arabidopsis Genome ATH1 Array C. elegans Gene 1.0ST Array C.elegans Genome Array Drosophila Gene 1.0ST Array Drosophila Genome 2.0 Array E.coli Genome 2.0 Array Yeast Genome 2.0 Array Zebrafish Gene 1.0ST Array Zebrafish Genome Array Other - Please Consult Us BEFORE Submitting Number of Microarrays(Required)Investigators may submit more samples than planned for microarray profiling (e.g., choose highest quality samples after initial QC). Please indicate the total number of microarrays to be performed. How did you isolate your RNA?(Required)Please indicate the exact name of the RNA Isolation Kit you used to prepare your samples. If you did not use a kit, please specify your process and place additional details in the "Final Notes" section of this form. Did you perform DNAse digestion (or similar process) during RNA isolation to remove genomic DNA?(Required)YesNoUnsureSample Volume and Concentration Information(Required)Please download and fill out the QC sample information excel sheet here before uploading it above. Sample names should NOT EXCEED 5 alpha-numeric characters. Please include all information requested or indicate "TBD" if unknown. Max. file size: 100 MB.AnalysisDo you require analysis from the BUMSR Computational Biology team?(Required)Basic gene-level analysis is available at no additional cost. Advanced analyses are available at additional cost to the microarray experiment.YesNoUnsureWould you like the remainder of unused sample returned to you after project completion?(Required)If you request sample return, the BUMSR Core will contact you to schedule retrieval or return shipping after microarray data delivery.YesNoUnsureFinal Notes