Immeuble BIOSTEP - Bâtiment A,
Rue Pierre et Marie Curie - BP38183
31681 LABEGE Cedex
Tel: 33 (0) 5 61 28 70 17
Fax: 33 (0) 5 61 28 70 11
E-mail: peptide@millegen.com
http://www.millegen.com		         

Peptide Synthesis Quotation Form

Demande de Devis
Requestor information
Name
Company or Institute
Address
City State
Zip code
Country
Phone Fax
Email
Billing address (if different)
Address
City State
Zip code
Country
Peptide details
Peptide name
Sequence N——C
N-terminal ending
Free amine
Acetylated
Biotinylated
Other, indicate

    C-terminal ending
Free amine
Amide
Biotin
Other, indicate
Quantity 2 mg 5 mg 10 mg Other, indicate
Purity 70 % 80 % 95 % Other, indicate
Modifications
Cyclisation
Conjugation
      with : KLHThyroglobuline Other, indicate
Fluorescent labelling
      with : Rhodamine FITC Other, indicate
Phosphorylation, indicate

OR


MilleGen® Immeuble BIOSTEP - Bâtiment A, Rue Pierre et Marie Curie - BP38183, 31681 LABEGE Cedex
Tél: 33 (0) 5 61 28 70 17, Fax: 33 (0) 5 61 28 70 11