EMMA Mutant Request Form

Dear Scientist

Please use the following form to request the mouse strains archived by EMMA.

Please complete all fields. Required information is marked by a * Click once on the Send button at the end of this form to submit your information to EMMA. You will receive an automatic email notification to acknowledge receipt of your request.

Thank you for your interest in the European Mouse Mutant Archive.

Recipient principal investigator

Scientist's Title

Firstname *

Surname *

E_mail *

Phone *

Fax



Shipping contact (animal facility manager etc.)

Shipping Contact's Title

Firstname *

Surname *

E_mail *

Phone *

Fax

Institution *

Department

Address line 1 *

Address line 2

County/Province

Town *

Postcode *

Country *


Billing address.Please provide a billing address.

VAT Reference * Only mandatory for orders from EU Countries.

Purchase Order Reference

Billing Contact address same as Shipping institute address.

Billing Contacts Title

Firstname *

Surname *

E_mail *

Phone *

Fax

Institution *

Department

Address line 1 *

Address line 2

County/Province

Town *

Postcode *

Country *

Requested strain:

EMMA ID

Strain name

Common name(s)

Requested Material: *


This stock is distributed from ICS, Institut Clinique de la Souris, France, EMMA node. Additional stocks may be distributed from other EMMA repositories.

Current availability:-

 

Live mice on shelf. Delivered in 4 weeks (after paperwork in place). €3200, plus shipping costs.

Frozen sperm. Delivered in 4 weeks (after paperwork in place). €1600, plus shipping costs.

 

Due to the dynamic nature of our processes, strain availability may change at short notice. The local repository manager will advise you in these circumstances.

Type of user: *

Academic user (non-profit research)

Commercial end user Information for industry users

Commercial service provider merely providing service of import and/or rederivation (non-profit research)

         Affiliation of academic end user



 

By checking this box I confirm I have read and understood, and agree to the EMMA repository conditions and the data privacy statement, and also agree to pay the service charges plus shipping cost.

(Click on the "Send" button once to submit the form to EMMA.)