MALDI-Q-TOF Sample Submission Form

							             MALDI-Q-TOF Sample Submission Form
             PEPTIDE MASS FINGERPRINT OR MSMS ANALYSIS

    Purpose: To use proteolytically or chemically cleaved protein fragments to identify a protein
                                        Customer Details
Contact Name:                                Principal Investigator:
Phone:                                       Fax:
E-Mail:                                      Organisation/Lab:
Billing Address:                             Customer#:


                                         Sample Details
Sample name:
Sample format: solid/liquid/PVDF/gel
Approximate MW:
Approximate pI:
Additional Notes: (Please provide any additional details relevant to the sample)




Species:
Quantity of protein           pmole. Concentration           µM. Estimated purity (%)
Method of purification:
If purified by electrophoresis please state stain used:
Do you suspect the protein is modified, eg. Glycosylation?
If the sample is a liquid, what solution is the sample in? Please state buffer and salt
concentrations:
# Of suspected PTM sites:
Cleavage agent: eg. Trypsin, CNBr, etc.
Special handling of sample:
For database searching please include the chemicals used for reduction and alkylation, if any:

Service:                     Database search required:                 ZipTip Clean Required:
Maldi-q-TOF MS/MS                Yes:       No:                               Yes:       No:
Maldi-Q-TOF PMF                  Yes:       No:                               Yes:       No:
                                        Send Sample To:
Mr. David McLeod                                  E-mail: protein@post.queensu.ca
Protein Function Discovery Facility               Phone: 1-613-533-3164
Queen's University                                Fax: 1-613-533-2497
614 Botterell Hall, Stuart St.,
Kingston, ON, Canada

I have read and understood the PFD Mass Spectrometry Price List and agree to the charges. I
have also prepared the sample(s) according to PFD’s guidelines (available upon request)

Print Name                                Sign Name                               Date
Samples are placed in a queue upon receipt with the completed form. For urgent and other
services, please contact us via e-mail protein@post.queensu.ca. Payment by credit card preferred.