FCRC Sort Waiting List Form

Rockefeller University FCRC Online Sort Waiting List Form

Please fill every item on this form or it will NOT be submitted. If you answer "Other" to any question you will be contacted by FCRC for details.

*Please enter your RU Username (such as smithj and NOT smithj@rockefeller.edu):

Date and Time
*Date requested:    
*Start time requested: Flexibility:
(Ex: same day)

Duration suggested:

Cell Sorter Choice
Does not matter
Not sure, need to discuss

*Human cells?

*List the date of the sort in the past:
*List the Cell Sorter used in the past:         
Sample Information
*Will the samples be fixed before submission to FCRC?
List type of sample:
*Eucaryotic cells:   
*Description of cells: (source; ATCC#)
*Does sample contain any known infectious agent? (NOTE! If this sample has had contact with ANY human pathogen you MUST check yes. This includes during culture, preparation, experimental procedure, or from a patient sample)
*Are the cells genetically modified?
*Pre-sort Purification/Enrichment of the Sample?
*Number of Samples:
*Collection Type:
*Total number of cells in experiment: x 106
*Final cell concentration of samples: x 106 to x 106
(Hold the option key and click to select multiple options on a PC, apple key and click for a Mac.)
Please enter any additional fluorochromes not in the list above:
*Dead Cell Exclusion Dye:
Additional Notes and Comments: