Transgenic Construct Submission Form

Document Sample
Transgenic Construct Submission Form Powered By Docstoc
					Mouse Model – Knockout/Knockin Request
                                                                          Animal Care Services
                                                                          Mouse Models Core

PI: ___________________________________              Date Submitted: ___________________

ES cell name (<10 characters, no Greek letters) and clone #s: _________________________

Contact person: _________________________________________________

Contact person info:

       Phone #1: ___________________          Phone #2: __________________

       FAX: ______________________            Pager: _____________________


SERVICE DESCRIPTION: Murine embryonic stem cells will be injected into at least 40
blastocysts isolated from females of the appropriate host strain per targeted ES cell line. We
expect 10-15% high percentage chimerism per live births, with significant variation between
constructs. Unless you indicate otherwise, we shall automatically test breed any chimeras
produced upon attainment of breeding age. C57BL/6J or C57BL/6J-Albino host animals are our
standard strains, and will be used according to the cell line injected. This additional service,
along with the tail clipping of any resulting germline pups is offered by us at just the cost of the
ACS Mouse Breeding Intermediate per diem rate. Before service, you will need to provide some
information about the targeting vector, ES cell line, place of transfection and screening, and
some administrative details. Contact Mr. Ryan Fiske after completing this form. He can be
reached at 352-273-8324, CGRC Rm. 556, or He will arrange a meeting with
you to discuss scheduling your injections, and to review the construct information. All services
are performed in the order received and are kept confidential.

The fee for this service, as well as the electronic version of this form, can be found at the
following website:

Base ES cells used for Transfection: ___________________

GENE STRUCTURE: Diagram the targeting vector and label salient features, including the
targeting arms, intron/exon boundaries, and size of each sequence.

FMACS244                                                                                      1 of 3
Mouse Model – Knockout/Knockin Request
                                                                     Animal Care Services
                                                                     Mouse Models Core

SPECIAL CONSIDERATIONS/INSTRUCTIONS: Please indicate below any special
instructions that we may need to carry out during any portion of the assigned project:

ES CELLS TRANSFECTED: Provide the name of the facility where ES cell transfection was
performed and the method of screening.

equivalent results. Information about submitting targeted ES cells for testing can be found at

FMACS244                                                                                2 of 3
Mouse Model – Knockout/Knockin Request
                                                                         Animal Care Services
                                                                         Mouse Models Core


PI: ________________________________

The following Chart Field Stream information must be provided for billing:

       * Department ID:

       * Fund Code:

       * Program Code:

         Source of Fund:

         Project Code:

         Flex Code:

       (* items are required)

If the work will be paid for with funds from outside of the University of Florida, they must be
paid by check in advance to the ACS Business Office; (352) 392-0526.

PI signature: ___________________________________________

ANIMAL TRANSFER: We will automatically assign you a new breeding project # and transfer
any chimeric animals produced to our breeding protocol upon weaning unless you instruct us
otherwise. We can test breed chimeras and subsequent germline carriers for you at minimal
extra cost to you. Before we begin, we will need an Institutional Animal Care and Use (IACUC)
protocol number for your project, and a location to transfer the mice. The IACUC protocol need
only be for the analysis of the animals - the Core Facility has IACUC approved protocols for the
procedures used to generate and breed the animals for you.

IACUC number_____________________________

Have ACS test breed chimeras upon weaning? __________________

If “yes,” which background strain to test breed to? ___________________________________

If “No” to above, transfer animals to Building: ________________ Room #: __________

FMACS244                                                                                    3 of 3