Systems Quote Request

Systems/Products

Thank you for your interest in Transgenomic. Please provide the following information:

As always, we respect your right to privacy. The information that you provide will not be released to any other organization.

Name *
Company/Institution *
Position *
Phone *
FAX
E-mail *
Address *
Address
City *
State/Province *
Zip/Postal Code *
Country *

Which systems should be quoted? * (check all that apply)
WAVE^® MD System 4000 Plus
WAVE^® System 3500	WAVE^® HS System 3500
WAVE^® System 3500A	WAVE^® HS System 3500A
WAVE^® System 3500HT	WAVE^® HS System 3500HT
WAVE^® System 4500	WAVE^® HS System 4500HT
WAVE^® System 4500HT-HS
HANABI-PII Metaphase Harvester	HANABI Metaphase Spreader

Which accessories should be quoted? * (check all that apply)
Fragment Collector Model FCW 200	Fluorescence Detector
Fragment Collector Model FCW 180	WAVE HSD-High Sensitivity Detector Module
Autosampler

How did you hear about Transgenomic?

What are your sample source(s)? (human, animal, plant, etc)

What are your gene(s) of interest?

* Required Fields

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