Yale/YCC Targeted Mutagenesis Order Form

Your Name:
Your PI:
Institution:
Department:
Charging Instructions:	Project	Task	Award	Expenditure	Organization

YCCC Member?:	Yes No
Room/Building:
Phone:
Fax:
E-mail:

Name of Targeting Construct:
Have you met with the Targeted Mutagenesis Service prior to designing your targeting construct?	Yes No
Would you like to arrange for such a meeting?	Yes No
Selection cassettes used:	Neomycin TK Other - Specify
Length of Homology:	5' Arm: 3' Arm:
Total length of linearized construct:
DNA Concentration:
Date DNA Submitted:

Click "Submit Order" to submit order electronically