Ship or deliver samples to: Genomics Core c/o Graham Wiley Oklahoma Medical Research Foundation 825 NE 13th Street, Research Tower Rm 2101 Oklahoma City, OK 73104 Genomics Core Sample Submission Form Sample Requirements SequencingDNA: Whole genome- 100ng in 60uL H2O or 10mM tris Exome- 700ng in 60uL H2O or 10mM Tris RNA: 1ug in a wet ethanol pellet MicroarrayRNA: A total of 1ug of RNA at a concentration of 100ng/uL in 3 aliquots as follows. Tube 1: 5uL, Tubes 2 and 3: 2.5 uL Shipping and Delivery Instructions Please ensure there is sufficient refrigerating material with your samples. The Genomics Core is not responsible for samples which are compromised due to improper shipping. If not hand delivered to the lab, samples must be shipped overnight for next day delivery. Please email the tracking number to bebakm@omrf.org. DNA: Bring on ice or with cold packs, ship on dry ice RNA: Send samples on dry ice Please complete the applicable sections of this form. Your samples will not be processed until a completed form is received. You may either send a copy of this form with the samples or email the form to bebakm@omrf.org 1. Contact Information Submitter Name email Phone 2. Billing Information Fax PI Name Phone Institution Fax Address email City State Zip 3a. Assay and Sample Information (Microarray) Array Type: Human HT-12_v4 Mouse WG6_v2 PO/Account# Species: Mouse Ref-8_v2 Number of Samples: 3b. Assay and Sample Information (Sequencing) Sequencing Method: HiSeq HiSeq Rapid Run MiSeq Sample Type: FFPE DNA DNA Version 1.3-20140714 RNA Amplicon Cycles Library Number of Samples: Sample Format: Number of Samples per Pool: Tube Plate Plate Map(s) Included: Species: With Shipment Via email 4. Project Description- please be as detailed as possible (Sequencing) Please attach a pedigree diagram if applicable. Sample Phenotype(s): Sample Relationships: Gene(s) of Interest: Additional Information: For information on the Bioinformatics Support offered by the Genomics Core, please visit our website. Version 1.3-20140714