National Agricultural Proteomics Research & Services Unit (NAPRSU)

Department of Biotechnology, University of Western Cape

Private Bag X17 Bellville 7535. South Africa

Robert Sobukwe Road

Bellville 7535

Republic of South Africa

Telephone: +27 21 959 2468/2066 Fax: +27 21 959 1551 e-mail. -

Proteomics Services Request Form
Contact Details (Name & Organisation) / Sample Information
Name(Customer):
Institution: / Type (e,g. microbial culture, animal or plant tissue, intact protein, tryptic digests, peptides, polymers, small molecules, etc)
Full Postal Address: / Organism/Species (e.g., human, plant, E coli, etc.)
Sample Form (e.g., dry, in solution, gel, tissue section, staining method (e.g., Coomassie; H&E), etc)
Telephone: / Fax:
E-mail:

For each sample the following information MUST be provided:

Samples / MW (kDa) / Number / Amount (mg) or Concentration (mg/mL) / Transport/Storage/Package (dry ice, sunlight, etc) / Safety and toxicity considerations where applicable.
1
2
3
4
5

Preliminary discussions on the optimized study designs are strongly recommended before sample submission. In particular, 1D/2D SDS PAGE samples must be submitted accompanied by a matching and labelled copy of the gel image in the proper front orientation, i.e., MW markers on the left, dye front at the bottom, where applicable. A hard copy has to be signed by the Customer and Supervisor.

Signatures: (Customer)______Date:______

(Supervisor)______Date:______

(NARPSU) ______Date:______

Excellence in Research & Development – A Place of Quality, A Place to Grow

National Agricultural Proteomics Research & Services Unit (NAPRSU)

Department of Biotechnology, University of Western Cape

Private Bag X17 Bellville 7535. South Africa

Robert Sobukwe Road

Bellville 7535

Republic of South Africa

Telephone: +27 21 959 2468/2066 Fax: +27 21 959 1551 e-mail. -

Excellence in Research & Development – A Place of Quality, A Place to Grow

National Agricultural Proteomics Research & Services Unit (NAPRSU)

Department of Biotechnology, University of Western Cape

Private Bag X17 Bellville 7535. South Africa

Robert Sobukwe Road

Bellville 7535

Republic of South Africa

Telephone: +27 21 959 2468/2066 Fax: +27 21 959 1551 e-mail. -

Excellence in Research & Development – A Place of Quality, A Place to Grow