SeeDNA Biotech Inc.
Antibody Detection Order Form

1. Antibody(Ab) information
Name of Ab: ______________
Generated from:
__ mouse      __ rabbitt
__ others: _____________________

Type of Ab: __ polyclonal    __ monoclonal
Concentration/Dilution of Ab:: ____________________
Dilution used in Western blot:
__________
Suggested dilution for immunostaining:: _________________
2. Requisition
Detection in: __ human cell    __ mouse cell    __ specific cell line   
Detection for:__Cellular localization,__Nuclear/chromosomal localization,
                    __Localization on mouse meiotic chromosome
                   :__Specific request:_____________________________
Catalog number: ___________
3. Customer information
Contact: _________________________                       E-mail:___________________
Principle Investigator: ______________________      E-mail:___________________
Tel (important): ___________________                      Fax:    ___________________
Shipping address (including department/institute/company):

______________________________________________________________

______________________________________________________________
4. Billing Information
Contact:__________________________
Department:_______________________
P. O. #:__________________________
Tel: _________________________
Fax: _________________________
E-mail: ______________________
5. Additional photos ___ sets,     Presentation slides ___ sets,   
    Rush service: __ Yes    __ No
6. Where did you hear SeeDNA? (Please check all which apply)
__ letter from SeeDNA     __ collaborators or colleagues     __ advertisement
__ searching internet     __ from SeeDNA's distributors     __ other: ___________________
7. Please read the terms of "Service Agreement" before you sign this order form.

Your signature:__________________________  Date: ________________
Please send the completed form to:
Customer Service, SeeDNA Biotech Inc., 443 Ouellette Avenue, Suite 100, Windsor, Ontario, Canada N9A 4J2
Tel: (519) 252-8669 , Fax: (519) 252-2915 E-mail: URL: http://www.seedna.com

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