rLV Vector Request Form

Children's Hospital of Philadelphia Research Vector Core

Request Date*

Requestor Name*

Requestor Email*

Requestor Phone Number*

Principle Investigator*

Institution*

For Internal Investigators

Lawson Number

For External Investigators

Shipping Address

Shipping Account

Billing Address

PO Number
Please contact core staff for credit card payment.

Custom Research Grade rLV Vector

Viral Vector Name

Vector Application / Target Tissue

rLV Pseudotype

VSV-G Pseudotyped Other Pseudotype, Please Specify

If Other Psuedotype, Please Specify

Production Requirement
Target Amount

Production Requirement
Minimum Titer (if required)

Quality Control Request

Particle Titer by qRT-PCR

Functional Titer by Flow Cytometry

Transgene Plasmid

Promotor
Name and Source

Transgene
Name and Source

Biological Activity of Transgene

Cloning Request

Yes No

If Yes, Please Specify

Plasmid DNA Amplification Request

Yes No

Amount of Plasmid Provided

Endotoxin Removal of Plasmid DNA

Yes No

Sequence Confirmation and Integrity Check
The plasmid has undergone sequence confirmation through both ITRs and the necessary steps to ensure plasmid quality and purity. Compromised plasmid integrity can lead to poor viral yields. Please check the box to acknowledge your compliance

Yes No

File Attachments
Please provide the analysis results along with the map and sequence of your vector indicating the following elements: ITRs, promoter, transgene, poly A where applicable and any other intact elements..

Comment or Special Requests

Send me a copy of my responses

Email address

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