Species and Strain Request Form

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Requestor Information:

Name *

Email Address *

Sites *

Instructions:

Species Common Name *

Species Scientific Name *

Strain *

Also Known as (if applicable)

Construct (if applicable)

Background strain (if applicable)

Transgenic *

Gene(s) and Genotype(s):

Gene-1

Gene(s)

Genotype(s)

Gene-2

Gene(s)

Genotype(s)

Gene-3

Gene(s)

Genotype(s)

Gene-4

Gene(s)

Genotype(s)

Commercial Vendor *

Select all that apply

Charles River Laboratories

脡levages du Haut St-Laurent

Envigo

Import (including In-House Breeding and from AMS Researchers)

Jackson Laboratory

Marshall BioResources

MICAM

Taconic Biosciences

Other (ex. capturing wild animals)

Vendor code

Leave this field blank

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