eBio Custom Quote Request

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First Name

Last Name

Name of Institution

Department

Fax

Telephone

Street Address

City

State

Postal Code/Zip

Will this be consumed for academic use?

Yes

Please describe your intended use of material. (Fill in 250 limit)

Please specify

Catalog number

Specificity

Clone

Quantity to order

Quantity

If custom, please specify

If other, please specify

Application

Additional details / notes

Species of interest

Number of tests

Number of tests per vial

Anticipated order frequency

Type of starting material (e.g. normal, antibody, fragment)

Host species

Isotype

What buffer is the antibody stored in?

If yes, please specify

Concentration (mg/mL)

If yes, please specify

Enter actual amount

Enter desired concentration

Enter desired formulation

Enter desired bottling (e.g. 10 vials at 1mg per vial, or 1000 tests per vial)

Desired application

Testing needed (additional cost may apply)

Cells of interest/gating scheme description

Notes or comments

Antigen / target

[+]

Desired clone

[+]

Desired fluorochrome

[+]

Instrument Information

UV(325 - 355nm)

Violet (405 nm)

Blue (488 nm)

Green (532 nm)

Yellow or Yellow Green (561-570 nm)

Red (633-647 nm)

Other

UV Machine Filter Configuration/ Available Channels

Violet Machine Filter Configuration / Available Channels

Blue Machine Filter Configuration / Available Channels

Green Machine Filter Configuration / Available Channels

Yellow Machine Filter Configuration / Available Channels

Red Machine Filter Configuration / Available Channels

Other Machine Filter Configuration / Available Channels

Target

[+]

Species

Manufacturing demand

Project description

Number of samples

Sample type

Test concentration

Target Cells

Controls

Acceptance criteria

Assay details

Anticipated annual purchase:

Please describe your custom project

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