Rederivation

Rederivation service order form

Please fill out this form and we will get in touch with you shortly.

Institution*

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Group Leader*

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Investigators in charge*

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Email*

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Name of strain

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Fleming ID No

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Source

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Does it contain:

TransgeneTargetedBothOther Invalid Input

Genetic background info

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Is there a fertility problem?

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Are available donors?

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Availability of fertile males

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Strain(s) chosen for rederivation

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Purchase Order No.

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