<p>Please complete the form and submit to [email protected]. Our service representative will contact you shortly with a quote.</p><p>Page 1 of 2</p><p>Customer Information If you have an existing account with ProteinCT, just fill in your name and email address or your Account No. Name of Requestor: First: Last: Middle: Title: Account No.: Name of PI: Organization: Phone: Fax: Email Address: </p><p>Shipping Address</p><p>Project Information Nature of Pricing estimation Quote for ordering For grant application purpose Inquiry Immediately 1-3 months 3-6 months Estimated Project Initiation >6 months Other, please specify </p><p>Intended Use Research use only In vitro diagnostics (IVD) Antibody drug development </p><p>Quick Quotation - Simply provide protein name, accession number and intended application(s), we’ll select one of our standard packages and send you a quotation shortly. For other customized service, fill out more detailed requirements on the next page. - If this section is completed, the next page can be left blank. Protein name: Accession number: Target: Species: MW: Western Blot ELISA ICC/IF IF Flow cytometry Intended application: Check all that may apply Immunoprecipitation (IP) Paired sandwich immunoassay development Other, please specify: </p><p> A set* of independent antibodies, 0.5mg each (lyophilized ascites fluid)  Standard deliverables: A set* of synthetic peptide antigens against which an antibody has been raised, 0.1mg each  1:100,000 ELISA titer guaranteed *number of antibodies and peptides depend on selected pilot package selected</p><p>Comments:</p><p>Please complete the form and submit to [email protected]. Our service representative will contact you shortly with a quote.</p><p>Page 2 of 2</p><p>Custom Service Specifications Please fill in project requirement details for a more customized quotation. If the Quick Quotation is completed on page 1, this section can be left blank. Protein name: Accession number: Species: MW: Target: Protein sequence: Please indicate mutations/variants as compared to the sequence corresponding to the accession number. </p><p>Posttranslational Phosphorylation Methylation Acetylation Other, please specify: Modifications (PTM): Please provide details of the site of modification, including sequence: Western Blot ELISA ICC/IF IF Flow cytometry Intended application: Check all that may apply Immunoprecipitation (IP) Paired sandwich immunoassay development Other, please specify: </p><p> We recommend use ProteinCT prepared antigen for immunization: Peptide </p><p>Conjugation to KLH</p><p>Recombinant protein </p><p>If recombinant protein is selected, please also fill out the Protein Expression Purification Service Quotation form  User supplied immunogen: Antigen: Name of Immunogen: Format (e.g. liquid, powder, gel, etc.) Volume and vials: Concentration: Human/Animal Health Hazard: Yes No</p><p>Precautions: </p><p>Immunoglobulin Class Desired: IgG IgM Either</p><p>Special Instructions:</p><p>Primary Plates First Assay: Method: ELISA Western Other</p><p>Special Instructions: Fusion and clone Primary Plates Second Assay: selection: Method: ELISA Western Other</p><p>Special Instructions:</p><p>Re-clone Plates Assay: Method: ELISA Western Other</p><p>Special Instructions:</p><p>Antibody production: In Vivo (ascites): 5 Mice per Clone In Vitro: Tissue Culture, 10 ml Supernatant from Each Clone Purification: No Antigen affinity Protein A resin Protein G resin Yes Check all that may apply: Biotin HRP FITC Other, please specify: Antibody modification: No</p><p>Lyophilized (standard, recommended) Desired amount: Delivery format: Liquid solution, please specify: (volume and concentration)</p><p>Comments: </p>