Download Service Account Set

FEE FOR SERVICE ACCOUNT SET-UP FORM
Date: ______ /______ /______ (month/day/year)
PI Name: _________________ (Last) __________________ (First) __________
Department: _______________________Institution: ______________________
Telephone: _____________ Fax: _____________ Email:_____________________
BILLING INFORMATION
Billing Address: Urb. Santa Juanita, Laurel Avenue, Microbiology and Immunology Department
Account Name: Biomedical Proteomic Facility (BPF).
Account Number: 1450-002639
Person in charge of the account: Dr. Nawal Boukli
SAMPLE INFORMATION
Please fill out the following table and include any important sample information (protein concentration, previous
preparation) with this form.
Biomedical Proteomic Facility (BPF) Used Only
BPF #:
Date Received:
Received By:
Sample Origin:
Sample
Name
Estimated
Amount
(µg)
Sample
solubilized in
1-D
gel
Service (check and fill out all that apply)
Protein
2-D
Staining
ID by
Poster
gel**
Method*
MS
.
*Coomassie blue= C
*ProQ Diamond Stain (Phospo-proteins) = P
*Sypro Ruby= S
Signature of the PI:_______________________
PPT
presenta
tions