Download DNA SEQUENCING SAMPLE SUBMISSION FORM

675 US Highway 1 South
North Brunswick, NJ 08902
Web: www.GENEWIZ.com
Voice: 1-877-GENEWIZ
Fax: 1-732-828-8790
Email: [email protected]
DNA SEQUENCING SAMPLE SUBMISSION FORM
Date:
Name:
Principal Investigator:
Address:
Email:
Phone:
Purchase Order #
Sample ID
Use 2 initial letters
and up to a 3-digit
sequential number
Fax:
Bill to:
Sample-Primer
(For your records)
DNA Type
1-Plasmid
2-PCR
3-Other (Specify)
DNA Size
Total length of
insert and vector
Special Requests
Specify universal primers
to be added at GENEWIZ
Data Return Preference: Check-off how you’d like to receive your report.
Email both sequences and electropherograms:
Macintosh Format
PC Format
Email sequences only
Other (Please specify)
Please keep a copy for your records. If you need more space, use as many
forms as necessary.
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