Download Application for Service:ES Cells

For internal use:
Targeting Core Project #: Click here to enter text.
Cell Lines to Inject: Click here to enter text.
Microinjection Project # Click here to enter text.
NINDS JHU Center for Neuroscience Research
Murine Mutagenesis Core Request Form, ES Cells
(Complete entire form and forward to Core Technician, Holly Wellington, [email protected])
Applicant PI: Click here to enter text. E-mail: Click here to enter text.
Applicant:Click here to enter text.
E-mail: Click here to enter text.
Department: Click here to enter text.
Phone:Click here to enter text.
-------------------------------------------------------------------------------------------------------------------------------------------------Construct Information:
Construct Name: Click here to enter text. Drug selection required: Click here to enter text.
Strain of Arms of Homology: Click here to enter text. Size of arms: Click here to enter text.
--------------------------------------------------------------------------------------------------------------------------------------------------Project Rationale: Click here to enter text.
NINDS* Grant # /Title: Click here to enter text.
*or other funding source
Specific Aim(s) of grant addressed by project: Click here to enter text.
--------------------------------------------------------------------------------------------------------------------------------------------------Terms of Use:
Because the Murine Mutagenesis Core is supported by NINDS, all publications involving work done in the Core
must comply with the NIH Public Access Policy (see publicaccess.nih.gov). It is the investigator’s responsibility
to ensure compliance.
Investigators are required to cite the Core (NS050274) in the Acknowledgments section of any publication that
results from use of the Murine Mutagenesis Core.
Investigators are required to inform the Core Technician, Holly Wellington, when a paper which makes use of
the facility is accepted for publication.
Investigators are encouraged to inform the Core Technician, Holly Wellington, when a mouse generated by the
Core is shared with another lab. It is the applying lab’s responsibility to maintain records which allow tracking
of such sharing.
Pursuant to NIH policy, mice generated by the Murine Mutagenesis Core must be shared with the scientific
community once initial publication has occurred.
Applicant: Please enter name and date below to indicate acceptance of terms outlined above.
Applicant: Click here to enter text.
Date: Click here to enter text.
Laboratory PI: Please enter name and date below to indicate approval of the Application for Service
and acceptance of terms outlined above.
Approved by Lab PI: Click here to enter text.
Date: Click here to enter text.
--------------------------------------------------------------------------------------------------------------------------------------------------Murine Mutagenesis Core Facility Contact Information
Core Technician/Investigator Contact: Holly Wellington, 4-3858, [email protected]
Core Manager: Chip Hawkins, 4-3858, [email protected]
Core Director: Xinzhong Dong, PhD, 2-2993, [email protected]
Center Director: Alex Kolodkin, PhD, 4-9499, [email protected]
--------------------------------------------------------------------------------------------------------------------------------------------------For internal use only:
Approved by Core Technician: Click here to enter text.
Date: Click here to enter text.
Approved by Core Manager: Click here to enter text.
Date: Click here to enter text.
Approved by Core Director: Click here to enter text.
Date: Click here to enter text.
Category: Center Investigator☐
Other NINDS Investigator☐
Non-NINDS Investigator☐