EUROSEQUENCE
Meditech Center - L.J. Zielstraweg 1 - 9713 GX Groningen - The Netherlands
Telephone: +31 - 50 - 317 2424 - Fax: +31 - 50 –317 2420
E-mail: info@eurosequence.nl - Internet: www.eurosequence.nl
Order form PROTEIN SEQUENCE analysis
ESQ Order number ....................
ESQ Client number ....................
Date of request
Order number
Name
Company/institute
Department
Address
Zip code and City
Country
Telephone
Fax
E-mail
Internet
Billing address
:
:
:
:
:
:
:
:
:
:
:
:
:
VAT number (only for E.C. countries other than The Netherlands) :
Sample name
:
Other Storage conditions? (-20oC is standard) :
Analysis requested :
[ ] N-terminal sequence
[ ] Internal sequence
[ ] C-terminal sequence
- Number of amino acids to be determined :
- under GcLP/cGMP
: [ ] Yes
[ ] No
Reason for Sequencing : [ ] identification
[ ] DNA probe
[ ] purity check
Customer allows protein database search via internet (FREE of charge) :
[ ] Yes
[ ] No
Options
[ ] Reduction & alkylation for positive identification of Cys
Other requests :
Customer herewith accepts our General Terms of Sale 1993 of which he/she declares having received a copy. These
Terms designate the Dutch Law as applicable law, and the Court in Groningen as competent Court.
Customer signature:
……………………………………………………………..
P.T.O. >>
Version: December 2007
SAMPLE INFORMATION
Quantity (pmol or µg)
: .............................…..
Volume (if applicable)
: .................................
Molecular Weight
: .................................
Origin
: .................................
Purity
: .................................. (%mol/mol protein)
(please provide buffer information below)
Special Characteristics
(please fill in, if relevant)
- chemically modified
: ....................................................................... (e.g. alkylation)
- chemically cleaved
: .......................................................................
(e.g. CNBr)
- enzymatically cleaved
: ......................................................................
(e.g. trypsin)
- radioactivity
: .......................................................................
Non-Protein / Buffer salts Contaminants
(indicate concentrations or total quantity of each contaminant):
......................................................................................................................................
Other relevant information :
......................................................................................................................................
Version: December 2007