Form to Request Gene Targeting in ES Cells

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PI Date
Contact person Lab room
Phone Email
Department Cancer Center member?
PTAO Funding source NIH etc.
Gene name Construct name
Construct linearizing enzyme    

Concentration (1 ug/ul after linearization)

Volume (60 ul)
Positive selection Negative selection
LoxP site location FRT site location
5' restriction enzyme(s) 3' restriction enzyme(s)
5' probe 3' probe
Expected wildtype band Expected wildtype band
Expected mutant band Expected mutant band
The PI/lab built the targeting vector or GTTF built the targeting vector (check one)

Brief description of the gene and aims of the targeting experiment (please provide a map of the construct):

GTTF will produce a targeting vector in a timely manner.  There is no guarantee that the gene targeting will succeed in ES cells, since this depends entirely on the accessibility and targeting frequency of the gene itself, which is unknown until attempted.  However, our track record has been successful and we are experienced with these procedures.

investigator's signature for agreeing to the terms

GTTF's signature for acceptance of the project

Please click "Submit" button to send the request electronically to GTTF.  Click "Back" button on your web browser to print, sign and bring the form to Jordan 2223 (ext. 2-3990) to confirm the timeline of the service.  Electronic signature is not available at this time.