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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:
Types:
Peptide
Sequence name:
Length:
Peptide scale of
synthesis:
Amount needed:
Purification code:
Modification:
Labeling:
Conjugation:

Sequence #1

 
Peptide
Sequence:
NH2 to COOH
OR complete another sequence below
If other scale, Please call 650-964-2589
Credit Card #:

Sequence #2

Types:
Peptide
Sequence name:
Length:
Peptide scale of
synthesis:
Amount needed:
If other scale, Please call 650-964-2589
Purification code:
Modification:
Labeling:
Conjugation:
Peptide
Sequence:
NH2 to COOH
Other Code #:
Other Code #:
Peptide Chart
Peptide Chart
Peptide Chart
Peptide Chart
Peptide Chart
Peptide Code
Peptide Chart
Peptide Chart
Peptide Chart
Peptide Chart
This online order form can order two sequences 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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Antagene, Inc.
Toll Free: 1 (866) 964-2589
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info@antageneinc.com