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Date

PI

PTAO*

Contact person

Phone

Email

Department

UVa Cancer Center member?

Yes No

UVa Diabetes Center member?

Yes No

Gene name

Construct name

Concentration (1 ug/ul required)

Volume (~60 ul required)

ES cell line R1 CJ7 RW4 W4 D3 E14TG2a Bruce4 (B6) Other (indicate below)

Positive selection PGK-neo MC1-neo SV40-neo Pol2-neo MC1-hyg PGK-puro

Negative selection MC1-tk PGK-tk MC1-DTA PGK-DTA tk and DTA

Construct linearizing enzyme

Linearized construct size

Conditional Floxed target gene Floxed neo FRT target gene FRT neo

Screening method

Wildtype fragment size

Mutant fragment size

Brief description of the gene targeting experiment, and attach a map of the construct and a gel picture to show the established screening method.

PI signature

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.

Last modified on: August 24, 2007

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