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Job Requisition Form


[FrontPage Save Results Component]
Required by:
Authorized by:
Telephone No.
Room No.
Date:
PBI Contact No.
PBI Internal Order No.

(Please Note: Samples will not be processed without a Contract No. or Internal Order No.)

See back of page for sequencing information.

Yes PCR fragment            check box in PCR fragment

  DNA File Name Plasmid or PCR fragment size DNA Conc. Primer Name and  Synthesis Number Size Primer Conc.
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Author information goes here.
Copyright 1999 [OrganizationName]. All rights reserved.
Revised: September 14, 2001