gc experiment request form

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					                               Gene Chip Experiment Request Form
                                     Genomics Core Facility
                                     UMass Medical School
                                           Internal and External Academic

     Phyllis Spatrick, manager                                                          Currently, there are no discounts available.
     Phyllis.Spatrick@umassmed.edu
     Department of Molecular Genetics and Microbiology
     Room S5-116, Phone (508) 856-4076

     Date:                                                                       Speed Type Number:

     Requested by:                                                               Lab:               Phone:

     Principal Investigator:                                                     Department:



     Experiment Information

     Supplied as:                                         (RNA, cRNA, dsDNA, etc)                   column purified?              gel image supplied

     Array Name:                                               (Mouse Gene 1.0 ST, etc)                                    chips submitted

     Requested Service-be specific:

     My samples                 need initial qualitative assessment on gel or bioanalyzer

                                Please prepare samples, or                          Target is ready to be hybridized to chip

                                I have a data analysis plan (please state):

                                This is a follow up experiment to:



          Sample Name                   conc+ volume                 notes
1                                                                                   Input amounts required:
2                                                                                   50 to 500 ng of total RNA in 3ul or less.
3
4                                                                                   3' IVT Express Kit used for all classic 3' arrays
5
6                                                                                   Ambion WT Expression Kit and Affymetrix
7                                                                                   GeneChip WT Terminal Labeling Kit used for all
8                                                                                   Gene ST and Exon GeneChips
9
10
11
12
13
14
15
16
17
     Totals

				
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posted:9/29/2012
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