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Order Form for DNA sequencing services from Northwoods DNA, Inc.

Mail your well-padded samples to:                                                                                      1-800-606-2248
Northwoods DNA, Inc.                                                                                                 www.nwdna.com
44526 County Road 3
Solway, MN 56678.                                                        (Orders require a P.O.# or a credit card number.)

Date:_____________                                                                       

Services ordered by:

Bill to:

Email address:

Email address:

Organization:

Organization:

Street:

Street:

City/State/Zip:

City/State/Zip:

Phone:

Phone:

 

Purchase Order:

 

Or MC,Visa,AmEx#:

 

Expiration Date:

 

Signature:

Service requested:      

Standard sequencing ($6.00/run)____
96-well plate ($4.50/run)____
Ready-to-run tubes ($3.00/run)____
Ready-to-run plates ($2.00/run)____                                                                                                                                  Genotyping/Fragment Analysis ($8.50/run)____
Primer walking ($0.10/base pair)____ 
Double-stranded primer walking ($0.15/base pair)____
 

PCR Gel Purification required?   ____Yes ($6.00/sample)  ____Yes, 48+ ($3.00/sample)  ____No
PCR Column Purification required?  ____Yes ($2.50/sample)  ____Yes, 48+ ($1.50/sample)  ____No
Template Type (plasmid, PCR product, etc.): _________________________

Sequence Name
(your initials and sample #)

Primer:
____Northwoods adds
____Customer added

 

Sequence Name
(your initials and sample #)

Primer:
____Northwoods adds
____Customer added

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Additional Information: 

 

 

 

 

 

                                  

Sequence Name
(your initials and sample #)

Primer:
_____Northwoods adds
_____Customer added

 

Sequence Name
(your initials and sample #)

Primer:
_____Northwoods adds
_____Customer added

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