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UMMC Cancer Institute Flow Cytometry Core - MoFlo Cell Sorter Name of investigator:……………………………………………………………………………. email:……………………………………………………………………………………………………. Phone:…………………………………………………………………………………………………… Type of samples to be analyzed (please indicate cell type(s) and size, and fluorescent dyes used):……………….………………………………………………….. .....………………………………………………............................................................. ................................................................................................................... ................................................................................................................... ................................................................................................................... Sorting parameters (please indicate the populations of cells you are interested in collecting and if known the percentage of these cells in the total population):…………………………………………………………………………….. ………………………………………………………………………………………………………….. ............................................................................................................. ............................................................................................................. Please indicate the type of sort: Enriched ⃝ Purified ⃝ Single ⃝ Billing information Principal Investigator:……………………………………………………………………………. Department:………………………………………………………………………………………….. Contact information:……………………………………………………………………………… ⃝ I have IRB approvals for the projects. ⃝ I have followed all necessary Biosafety protocols. ⃝ I have read, understood and agreed to the terms and conditions of usage of this instrument. Signature……………………………………………………………. Date …………………………