. UNIVERSITY OF PENNSYLVANIA Location: Tel: Fax: Website: Mailing Address: D2 Richards Building 3700 Hamilton Walk Philadelphia, PA 19104-6085 D2 Richards Building 215/898-2795 215/573-9327 http://www.med.upenn.edu/genetics/cellctr/services.shtml _________________________________________________________________________ REQUEST FOR HYBRIDOMA GENERATION (FUSION) User Name: __________________________________________ Penn Key_____________________________________ Principal Investigator: _________________________________ Fund No/ PO No: ______________________________ Date: _______________________________________________ Tel: __________________________________________ Email: ______________________________________________ Fax: _________________________________________ Prices subject to change. Contact Cell Center Services for current prices. Antigen Information: Antigen Name:______________________________________________ Is Antigen: A Protein A Peptide Antigen concentration and amount: ____________________________ Antigen size: ____________________ kD In case of Peptide: Is the peptide conjugated to a carrier protein? If yes, which carrier? _____________________________ Please check the requested service(s) Peptide conjugation to KLH carrier protein Immunization: Fusion: number of mice _____________ (the one mouse with the best titer will be used for fusion) number of 96-well plates cells will be plated into ______________ Fusion maintenance and harvesting of supernatants for testing Screening of supernatants by ELISA Expansion and freezing of positive clones: Subcloning by limiting dilution: number of clones _____________ number of clones ___________________ Staff Use Only Start Date _______________________ Revised 02072012 Completed ______________________ By: _________________________