Custom Embryo Cryopreservation Interest Form

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First name

Last name

Verify email

Organization

City

Country:

State:

Province

Providence

Phone

Interest area

Import Source Contact Information

Same as requestor

YesNo

Contact Name

Contact Email

Contact Phone Number

Organization

Storage Contact Information (For receipt of our Annual Cryo Storage Report)

Principal Investigator Name

Principal Investigator Email

Organization

Technology Transfer Name

Technology Transfer Email

Main office email alias

Accounts Payable Name

Accounts Payable Email

Main office email alias

Other Contact Name

ex. Lab Manager, Administrative Assistant

Other Contact Email

Strain Information

Strain Name

Strain Background

Quantity of female mice available for shipment to JAX:

If you can provide 30 or more female mice, this can decrease the costs and timeline for the project.

We ask you provide 10-15 female mice at 6-12 weeks to JAX for in vitro fertilization procedures.

Quantity of male mice available for shipment to JAX:

We ask you provide 2 male mice that are 8-16 weeks of age to JAX for in vitro fertilization procedures.

Are there any known Husbandry issues with this strain?

YesNo

If yes, please describe:

Additional questions or comments about this project request

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Contact Information