Commercial Use: Cell Line Request Form
Cell Line Name / Catalogue NumberSNL 76/7 / 07032801
The cell line SNL 76/7 is the property of the Baylor College of Medicine. ECACC is able to supply these cell lines to commercial entities, or for commercial use or benefit, only upon executing a license with the Baylor Licensing Group. Requests for the commercial use of this cell line will be forwarded to Baylor upon receipt of the completed form below. Please complete this form and return to the Culture Collections.
Section 1 - CustomerPO/Order Number:Click here to enter text.
(Please enter your customer purchase order number, website reference or Culture Collections order number)
Name of requesting scientist:Click here to enter text. / Position:Click here to enter text.
Organisation:Click here to enter text.
Address:Click here to enter text.
Phone:Click here to enter text. / Email:Click here to enter text.
Intended Use of cell line:Click here to enter text.
Signed:
(requesting scientist) / Date:
Culture Collections contact details for the return of this form
Email: /
Fax: / +44 (0) 1980 611315
Post: / Culture Collections, Public Health England, Porton Down, Salisbury, Wiltshire, SP4 0JG, UK
Internal use only - Depositor / Technology Transfer Office
Terese Rakow, Ph.D.
Sr. Licensing Associate,
Baylor Licensing Group
Mail Stop: BCM210
One Baylor Plaza
Houston, TX 77030-3411
Main Tel: / 001 713 798-6821 / Direct Tel:
Fax: / 001 713 798-1252 / Email: /
Section 2 – Depositor / Technology Transfer Office - Authorisation for sale
Enquiry only: Is License Required? / Yes No
(select as appropriate) please do not contact company above
Order:Release of cell line / Approved Declined
Signed: / Date:
Print name:
Once signed please return this form to the Culture Collections using the contact details at the bottom of section one
Section 3 – Culture Collections - Authorisation for sale
Supervisor Signature: / Date:
Print name:
Culture Collections – a Public Health England biological resource
Supporting the scientific community with quality, integrity and expertise
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