P[acman] Microinjection Package Order Form

Please fill the form below (fields with are required). Once we receive your order, we will send you a quotation and confirm the order with you.
To ensure superior service, P[acman] Microinjection Package (US$566.5) includes BAC prep, Microinjection, and w+ Screening.

Sample and Service Option Information

#	DNA Sample			Fly Strain	Add-on Service	Note
	We request Pacman-containing EPI300 bacteria			Fly Strain	Add-on Service	Note
	Name* (Label on Tube)	Total Size* (kb)	Antibiotics* for BAC prep	Fly Strain*	Balancing Service	Leave your message here
0	Pge-413.5-P	13	Chloramphenicol	VK00033	Balancing (+US$32)	This is an example
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Subtotal of Service Fee

※Handling fee (US$36) and Shipping fee (US$69) will be charged additionally on each shipment.

Your Contact Information

Title

Full Name*

Email*

Telephone*

Institution/Company*

Principal Investigator/Group Leader Contact Information* Same as above

PI Title

PI Full Name*

PI Email*

PI Telephone*

PI Institution/Company*

CC your order to:

Shipping Address with Postal Code*

Billing Address with Postal Code* Same as shipping Address

Import Permit

Please provide us your import permit if necessary for importing live Drosophila melanogaster to ensure smooth clearance at your custom.

Confirmation*

I have read and agree to your Terms & Conditions.
I hereby certify that the above information is true and correct.

P[acman] Microinjection Package Order Form

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