FLUORESCENT SLIDE SCANNING REQUEST
Principal Investigator :
P.I. Email :
P.I. Phone :
P.I. Affiliation :
Contact Person (if not P.I.) :
Contact Email :
Contact Phone :
Billing Number : Date:
Number of Slides Submitted :
Magnification : 10X ¦ 20X ¦ 40X ¦ 63Xoil (please email if you need 63X)
Folder Name : - (optional folder name)
Channels to be scanned:
BLUE GREEN RED short RED long FAR RED INFRA RED
DAPI/Hoechst
/UV
Cy2/Alexa488
/FITC/GFP
Cy3/Alexa546
/TRITC/RFP
TxRed/Alexa594
/Alexa568
Cy5/Alexa647
/TOPRO/TOTO3
Cy7/Alexa750
/DyLight750
Counterstain channel :

Input the names of your slides in the SAME order in which they will be submitted
Limit to ≤ 16 characters - Alphanumeric only
DO NOT USE THE FOLLOWING CHARACTERS:
# / \ ; : [ ] { } . , & ! @ $ ^ * )(

Estimated Cost : $0.00


Optional - For your records only