Peptide Synthesis
Order Form
Peptide Synthesis Facility
Room 238/239/240 Center for Bioengineering
300 Technology Drive
Pittsburgh, Pennsylvania 15219
Telephone: (412)-383-9540/ 9015, Tele fax: (412)-648-0251
Please fill in all required fields indicated by *, thanks!
Contact Name
*
:
Address:
Telephone No:
Email address
*
:
Date of Request:
PI's Name
*
:
Address
*
:
Telephone No
*
:
Fax No:
Date of Request:
UPCI Member:
Yes
No
Peptide ID:
Account No
*
:
Grant Title
*
:
Peptide Sequence:
(
* Please use one upper case single letter code in each box
)
Free
Fmoc On
N-Terminus
C-Terminus
Free acid
Amide
N-terminus modification
Acetylation
Biotinylation
Fluorescein Labeling
15N or 14C Labeling
Other
Other modification
Cyclization
Phosphorylation
C-terminal biotinylation
Other
Purity
>70%
>80%
>95%
Other
Quantity
5-10mg
10-20mg
20-50mg
50-100mg
>100mg
Other analysis
AA composition
Peptide content
HPLC analysis
Other
