Mouse Model - Transgenic Request Animal Care Services Mouse Models Core PI: ___________________________________ Date Submitted: ________________ Construct name (short w/ no unusual characters): _______________________________ Contact person: _________________________________________________ Contact person info: Phone #1: ___________________ Phone #2: __________________ FAX: ______________________ Pager: _____________________ Email:___________________________________________________ SERVICE DESCRIPTION: - Plasmid or BAC transgenes will be injected for gene transfer into the pronuclei of fertilized, viable murine oocytes. - Standard mouse strains available for injection are FVB/NJ (inbred) or B6D2F1/J. - 30 live weaned pups will be produced from the injected oocytes, to screen for expression of the transgene - The fee includes the service of DNA purification by our designated lab. Be advised, if you choose to purify your DNA yourself, our guarantee of 30 live births will be nullified. - Tail snips from each resulting mouse will be taken upon weaning and given to investigators to detect founder animals. - The use of nonstandard strains for oocyte injection will be reviewed on an individual basis - Before service, you will need to provide some information about the transgene and some administrative details. Please fill out this form and then contact the Mouse Models Core Facility. The manager will arrange a meeting with you to discuss scheduling your injections, transfer the DNA, and to review the construct information. - All services are performed in the order received and are kept confidential. Questions and Contact info for this service: ACS-MMC@acs.ufl.edu The fee for this service, as well as the electronic version of this form, can be found at the following website: http://acs.ufl.edu/MouseModelCore/index.shtml Which strain of mice for embryo donors for injections? FVB/N (inbred) _______________ B6D2F2J (hybrid) _____________ Other (please specify) ___________ FMACS243-01 1 of 3 Mouse Model - Transgenic Request Animal Care Services Mouse Models Core GENE STRUCTURE: Diagram the transgene construct and label salient features, including the restriction sites used to release the transgene construct, the promoter, reporter, stop and start sites for transcription, stop and start sites for translation, intron/exon boundaries, and size of each sequence. SPECIAL CONSIDERATIONS/INSTRUCTIONS: Please indicate below any special instructions that we may need to carry out during any portion of the assigned project: FMACS243-01 2 of 3 Mouse Model - Transgenic Request Animal Care Services Mouse Models Core BILLING INFORMATION PI: ________________________________ The following Chart Field Stream information must be provided for billing: * Department ID: * Fund Code: * Program Code: Source of Fund: Project Code: Flex Code: (* items are required) If the work will be paid for with funds from outside of the University of Florida, they must be paid by check in advance to the ACS Business Office; (352) 273-9252. PI signature: ___________________________________________ ANIMAL TRANSFER: We will automatically assign you a unique breeding project # and transfer any transgenic founder animals produced to our breeding protocol for test breeding upon weaning unless you instruct us otherwise below. We can test breed founders and subsequent germline transgenics for you at minimal extra cost to you. Before we begin, we will need an Institutional Animal Care and Use (IACUC) protocol number for your project, and a location to transfer the mice. The IACUC protocol need only be for the analysis of the animals - the Core Facility has IACUC approved protocols for the procedures used to generate and breed the animals for you. IACUC number_____________________________ Have ACS test breed founders upon weaning? __________________ If “yes,” which background strain to test breed to? _______________________________ If “No” to above, transfer animals to Building: ________________ Room #: __________ FMACS243-01 3 of 3