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Copyright © 2006. All rights reserved. Antagene Inc.
1931 Old Middlefield Way, Suite #K  Mountain View, CA 94043
Tel 1 (866)964-2589 l Fax (650)964-2519 l info@antageneinc.com
Contact  webmaster
Contact Name:
Institute:
Shipping Address:
Phone:
E-mail:
Fax:
P.O.#:
Card Type:
Cardholder's Name:
Exp. Date:
Billing Address:
or
City, State, Zip:
City, State, Zip:
Antibody Types:
Peptide
Protein
or
If it is peptide antibody, please fill the following information
Sequence name:
Length:
Peptide scale of
synthesis:
Other scale:
Purification code:
Modification:
Conjugation:
Others:
Antibody #1
 
Peptide
Sequence:
NH2 to COOH
Type:
Antibody Name:
Antibody Type:
Complete Service:
Affinity Purification:
Elisa Test:
Phospho-Antibody:
Additional Items:
OR complete another sequence below
Antibody
If other scale, Please call 650-964-2589
If other, please specify below
Credit Card #:
Other Notes or
Requirement:
Antibody #2
Antibody Types:
Peptide
or
Protein
If it is peptide antibody, please fill the following information
Sequence name:
Length:
Peptide scale of
synthesis:
Other scale:
If other scale, Please call 650-964-2589
Purification code:
Modification:
If other, please specify below
Conjugation:
Others:
Peptide
Sequence:
NH2 to COOH
Type:
Antibody
Antibody Name:
Antibody Type:
Complete Service:
Affinity Purification:
Elisa Test:
Phospho-Antibody:
Additional Items:
Other Notes or
Requirement:
 
This online order form can order one sequence at a time. Large orders can be completed by sending information on multiple forms. If there's a problem with this form, you may send the information by E-mail to Sales@antageneinc.com or call 1-650-964-2589.
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