Service Form

Contact Name *

Email Address *

Phone Number *

University/Institution Name *

Submission Date *

Billing Contact Name

Billing Phone Number

Payment *

Distributor Name

Quote Number *

Number of Samples *

Number of Antibodies Provided *

Lysis Buffer Composition *

Do any samples contain viruses?*

Suggested Dilution*

Sample Storage*

FedEx Account #

Additional information

Additional File:

Do not upload POs here, email them to orders@raybiotech.com

Upload sample list:

Excel Template Download

Sample Info

#	Sample ID	Sample Type	Sample Species	Sample Volume	Suggested Dilution	Protein Concentration Or Determined By RayBiotech	Toxic/Infectious materials?	Indicate sample groups
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Antibody Info

#	Antibody ID	If antibody is from RayBiotech Auto-Western Library, list the Antigen & Species	If antibody is NOT from Auto-Western Library, list the Company and Catalog number	If antibody is NOT from Auto-Western Library or RayBiotech catalog, who is purchasing antibody?
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Special Request

#	Antibody ID	Antibody Dilution (if known)	Loaded Protein	Protein company/catalog Number	Dilution or concentration of protein	Any additional info/special instructions
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This service form is for the RayBiotech Auto-Western Service.

#	Sample ID	Sample Type	Sample Species	Sample Volume	Suggested Dilution	Protein Concentration Or Determined By RayBiotech	Toxic/Infectious materials?	Indicate sample groups
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2
3
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189
190
191
192
193
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195
196
197
198
199
200

#	Antibody ID	If antibody is from RayBiotech Auto-Western Library, list the Antigen & Species	If antibody is NOT from Auto-Western Library, list the Company and Catalog number	If antibody is NOT from Auto-Western Library or RayBiotech catalog, who is purchasing antibody?
1
2
3
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#	Antibody ID	Antibody Dilution (if known)	Loaded Protein	Protein company/catalog Number	Dilution or concentration of protein	Any additional info/special instructions
1
2
3
4
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#	Sample ID	Sample Type	Sample Species	Sample Volume	Suggested Dilution	Protein Concentration Or Determined By RayBiotech	Toxic/Infectious materials?	Indicate sample groups
1
2
3
4
5
6
7
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183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200

#	Antibody ID	If antibody is from RayBiotech Auto-Western Library, list the Antigen & Species	If antibody is NOT from Auto-Western Library, list the Company and Catalog number	If antibody is NOT from Auto-Western Library or RayBiotech catalog, who is purchasing antibody?
1
2
3
4
5
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7
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#	Antibody ID	Antibody Dilution (if known)	Loaded Protein	Protein company/catalog Number	Dilution or concentration of protein	Any additional info/special instructions
1
2
3
4
5
6
7
8
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81
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85
86
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91
92
93
94
95
96
97
98
99
100

#	Sample ID	Sample Type	Sample Species	Sample Volume	Suggested Dilution	Protein Concentration Or Determined By RayBiotech	Toxic/Infectious materials?	Indicate sample groups
1
2
3
4
5
6
7
8
9
10
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180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200

#	Antibody ID	If antibody is from RayBiotech Auto-Western Library, list the Antigen & Species	If antibody is NOT from Auto-Western Library, list the Company and Catalog number	If antibody is NOT from Auto-Western Library or RayBiotech catalog, who is purchasing antibody?
1
2
3
4
5
6
7
8
9
10
11
12
13
14
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81
82
83
84
85
86
87
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89
90
91
92
93
94
95
96
97
98
99
100

#	Antibody ID	Antibody Dilution (if known)	Loaded Protein	Protein company/catalog Number	Dilution or concentration of protein	Any additional info/special instructions
1
2
3
4
5
6
7
8
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11
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