Flow Cytometry Service Request

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P.I.

Contact Person		Ordered:
Location
Phone
Email		Fax
Describe Science:
Describe Science:

I'd like to reserve time on this date:

AA: Available AA: Reserved (Double click on an available start time) (To see why unavailable, hover over grid cell)

Instrument	08:00 AM	08:30 AM	09:00 AM	09:30 AM	10:00 AM	10:30 AM	11:00 AM	11:30 AM	12:00 PM	12:30 PM	01:00 PM	01:30 PM	02:00 PM	02:30 PM	03:00 PM	03:30 PM	04:00 PM	04:30 PM	05:00 PM	05:30 PM	06:00 PM	06:30 PM	07:00 PM	07:30 PM
Aria
Aria II
Cellomics
CyAn Analyzer
LSR II
Consultation

Instrument:

Start Time:
(Double click in a grid cell to select start time)

End Time:

, Minutes

Sorting Nozzle Size:

Price based on PI memberships.

= Total $

Billing
If outside USC, you may use a PO, including CHLA and Doheny Inst.

Payment Method:

USC Account Number
Purchase Order (PO)
Account will be provided later
Credit Card
Invoice

USC Account # or PO:

Organization

(optional)

Grant #

(optional)

Human Stem Cell research?

YesNo Under penalty of law, please honestly indicate if this order is for non-Federally approved Human Stem Cell research? Federal regulations require these projects not be subsidized by federal funds. If yes, additional costs may apply.

Invoice Mailing Address (POs)
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