GENEEffective VECTOR as of September CORE 1, 2015 LABORATORY Room R630, The Margaret M. Alkek Building for Biomedical Research

Request Service: go to iLab

Fax: 713-798-8764 Email : [email protected] or [email protected]

Name: Institution: P.I.: Ship / Pick-up (Circle One) Phone Number: Shipping Address (If Applicable): E-mail: PO: City: State: Zip:

1. Viral Vector

Identification Name______AAV FGAd HDAd LV RV

2. Quantity Submitted

Virus (FGAd and HDAd only) Shipping Conditions: dry ice

Titer ______Viral Particles (VP)/ml CVL ______Purified Ad ______

Shuttle vector (all viral vectors) Vector Backbone if not in ID______

Concentration _____ g/l Volume ______l No. Tubes ______Shipping Buffer______Shipping Conditions: room temperature

3. Quantity Requested

Standard ______Other ______

LV only: Purification ___ Concentration ____

Received by ______

Signature ______Date ______

3. Additional Quality Control Testing Requested

Infectious Titer by Q-PCR Identity Verification Test Others ______

FGAd: first generation adenoviral vector; HDAd: helper-dependent adenoviral vector; AAV: adeno-associated viral vector; LV: lentiviral vector; RV: retroviral vector.