Fragment Analysis Order Form
 
Name: 
Date: 
E-Mail: 
Phone: 
Lab PI Name: 
Department: 
Account Number: 
How do you want your sequences sent?  e-mail floppy CD FTP

*Note:Please leave an approproate number of blank CDs or floppy disks when delivering reactions if you choose either of those options.



Reaction
#
DNA Template ID #
(first,middle, and last 
initials followed by -#)
# of Primer Combinations
Example DLN-1 6
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Prepared by Researcher