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Pepchip™ Custom

Design your own peptide microarray!

You can use the following form to submit your order or to request a quotation for supply of the specified peptides printed on a glass slide.

FIELDS MARKED WITH * ARE REQUIRED!

To order A quotation

Peptide details Description of content to be spotted on glass slide

Type or paste protein or peptide sequences (single lette code, new line for each peptide)

N-termini Covalently bound to glass slide

C-termini
- Free acid
- Amide
Other, please specify:

Number of copies of the same peptide sequence per slide One
Two
Three
Four
Other, please specify:

Number of copies of the same slide one
two
three
four
Other, please specify:

Salutation:

First name*:

Last name*:

Company / Institution:

Position:

Email Address*:

Telephone number:

Fax number:

Street address 1*:

Street address 2:

Street address 3:

Zip / Postal code*:

City*:

State / Province*:

Country*:

Same as delivery address

Street address 1:

Street address 2:

Street address 3:

Zip / Postal code:

City:

State / Province:

Country:

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