National Laboratory for the Genetics
of Israeli Populations

Order Form

You may order any cell line from our catalog.

Print this page, fill out and sign the form, then send it by fax, along with an institutional purchase order to ++972-3-640-7611.

Please state the ethnic group and quantity requested for: frozen cells/growing cells/DNA samples:

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Give a brief description for the research project for which the cell lines or DNA samples will be used:

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Agreement

I, the undersigned, state that:

The requestred cell lines/DNA samples will be used in my laboratory only for research.
It is understood that the cell lines/DNA samples or their products will not be further distributed to other laboratories or any scientists.
No change will be made in scientific publications in the individual numbers of the cell lines or DNA samples.
Human cell lines/DNA samples may carry viruses, viral genes or other hidden contagious factors. I shall therefore take all the necessary steps to protect myself and my laboratory personnel who will handle these cells/DNA samples. It is understood that The National Laboratory for the Genetics of Israeli Populations, and/or Tel-Aviv University and/or researchers who contributed the cell lines to the National Laboratory's collection and/or the researcher institute in which these cell lines were originally prepared, will not be held responsible for any risks associated with these human cell lines/DNA samples.
I shall pay for the cell lines/DNA samples according to the price list of The National Laboratory for the Genetics of Israeli Populations.

Name: _ _ _ _ _ _ _ _ _ _ Date: _ _ / _ _ / _ _ _ _

Signature: _ _ _ _ _ _ _ _ _ _ Title: _ _ _ _ _ _ _ _ _ _

Phone: _ _ _ _ _ _ _ _ _ _ Fax: _ _ _ _ _ _ _ _ _ _ e-mail: _ _ _ _ _ _ _ _ _ _

Shipping Address:

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Billing Address:

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[Back to Tel-Aviv University]

To contact us:
Write: National Laboratory for the Genetics of Israeli Populations
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
Phone: ++972-3-640-7611
Fax: ++972-3-640-7611
e-mail: gurwitz@post.tau.ac.il