PEF Protein Research Services Enquiry Form

Please fill in as many details as possible about your project to assist us with providing you with an accurate quote.

CONTACT DETAILS

Contact Person*

First and last name

Group Leader / Principal Investigator name*

First and last name

Affiliation / Organisation*

Full name - no abbreviation

Faculty / Institute*

Full name - no abbreviation

Centre / Department / School / Unit

Full name - no abbreviation

Address*

Please provide your delivery address

Phone / Mobile*

Please include your country code

Email*

Please select the category below that best describes your organisation*

Select

PROJECT DETAILS

Would you like to discuss the project design with a PEF research specialist?*

Yes

Please select the services you would like included in your quote:

Select all that apply

Select

Which expression system would you prefer?

Bacteria

Yeast

Insect cell / Baculovirus

Mammalian

Undecided or not applicable

Project Description*

Please provide a brief project description, including the intended end application.

Please attached any relevant literature references, documents, images, results, etc:

Drag and drop files here or

Is this enquiry for a student project?*

Select

Do you require PEF to arrange shipping of the final sample on project completion?*

Yes

SAFETY AND REGULATORY INFORMATION

Are you sending samples from outside of Australia, originally from overseas, or subject to state quarantine restrictions?*

Yes

Do your samples require special storage or handling according to the OGTR (Office of the Gene Technology Regulator) or an IBC (Institutional Biosafety Committee)?*

Yes

Do your samples contain any hazardous substances?*

Yes

PROTEIN INFORMATION

Protein Name*

UniProt Number

Organism of Origin

Cellular Localisation

Intracellular

Membrane

Secreted

Unknown

Nucleotide Sequence

Amino Acid Sequence

Please include the start methionine, stop codon, any tag sequences and cleavage sites.

Would you like endotoxin removal? (required for animal studies)

Yes

Desired Yield

How did you hear about us?*

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If 'other' - how did you hear about us?

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