W.M. Keck Foundation Biotechnology Resource
Laboratory at Yale University

Small Scale Peptide Synthesis Order Form

PLEASE USE SINGLE LETTER CODES

1. (  )acetyl or (  )free NH2 
 [  ] purified 
 [  ] crude 
 ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 
 1   2   3   4   5   6   7   8   9   10 

___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 
 11  12  13  14  15  16  17  18  19  20 

___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 
 21  22  23  24  25  26  27  28  29  30 
 
 
  scale 
[  ] 25 然 
[  ] 50 然 
[  ] 100 然 

 

free COOH (  )  or CONH2 (  )
2. (  )acetyl or (  )free NH2 
 [  ] purified 
 [  ] crude 
 ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 
 1   2   3   4   5   6   7   8   9   10 

___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 
 11  12  13  14  15  16  17  18  19  20 

___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 
 21  22  23  24  25  26  27  28  29  30 
 
 
  scale 
[  ] 25 然 
[  ] 50 然 
[  ] 100 然 

 

free COOH (  )  or CONH2 (  )
3. (  )acetyl or (  )free NH2 
 [  ] purified 
 [  ] crude 
 ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 
 1   2   3   4   5   6   7   8   9   10 

___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 
 11  12  13  14  15  16  17  18  19  20 

___ ___ ___ ___ ___ ___ ___ ___ ___ ___ 
 21  22  23  24  25  26  27  28  29  30 
 
  scale 
[  ] 25 然 
[  ] 50 然 
[  ] 100 然 

 

free COOH (  )  or CONH2 (  )

 
SUBMITTER ____________________________   PRINCIPAL INVESTIGATOR ______________________

DATE ____________   TELEPHONE: ____________________   FACSIMILE ________________________

EMAIL ________________________________________________________________________________

SHIPPING ADDRESS ____________________________________________________________________

BILLING ADDRESS _____________________________________________________________________

P.O.# OR YALE CHARGE # ______________________________   DEPARTMENT __________________

ANY SPECIAL INSTRUCTIONS/UNUSUAL PROCEDURES, ETC. ________________________________

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FAX order to (203)737-2638