Mobley Research Laboratory: Department of Microbiology & Immunology: University of Michigan Medical School

Strain and/or Material Requests

Date (mm/dd/yyyy):

Name of Requester:

Name of Lab P.I.:


Street Address:




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):

Submit Request

Start Over

If you have problems sending this form, try this:

1-Save this page to your desktop as a text (.txt) file
2-Open the text file, fill out the form, and save as a text (.txt) file
3-Send the filled out form as an e-mail attachment to:

or, when all else fails...

Print this form and fax or mail it to:

Harry Mobley, PhD
University of Michigan
Department of Microbiology and Immunology
5641 Medical Sciences II 1150 W. Medical Center Dr.
Ann Arbor, MI 48109

FAX: 734-763-7163