Strain and/or Material Requests

Date (mm/dd/yyyy):

Name of Requester:

Name of Lab P.I.:

Affiliation/Organization:

Street Address:

City:

State:

Zip:

Phone number:

e-mail address:



Strains are shipped via FedEx and the recipient is responsible for providing a
FedEx billing/account number to which shipping costs can be charged.


FedEx billing number:

Strain and/or Materials Requested:


Publication referring to desired Strain/Material
(include page number on which desired material is specifically mentioned):


Proposed use of requested strain or material (required):