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Submission Form for Embryo Cryopreservation

C.B. Gurumurthy, Ph.D.
Mouse Genome Engineering Core Director
402-559-3338

Email

All fields are required.

Lab Information

Principal Investigator: 

Department/Institution: 

Email:

Contact Person:

E-mail:

Phone:

Person/Dept Billing should be directed:

Cost/Center Number:

IACUC approval number and title to Transfer Animals from:

Mouse Line to be Cryopreserved:

Strain of Mice to be Cryopreserved:

C57B1/6 FVB
129 CD-1
Other

Genotype: Homozygote Heterozygote

Can MGECF freeze this line as heterozygous? Yes No

Number of Stud Males: Age: Months or weeks?

If Mice must be maintained only as Homozygous: Number Females Age:

Present location of animals: Building: Room Number:

Provide Health Status REPORT

What is known about the reproductive status of these mice?

Average age if first litter: Average litter size:

How many litters are expected from each female?

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