User account

Account information

Username: *

Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.

E-mail address: *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

please follow the following instructions

Address

First name: *

Last name: *

Which of the below best describes your lab?

UCSF SABRE member

UCSF

Private Institution, for-profit

Academic Institution, outside of UCSF

This information helps us to establish the appropriate recharge rates for your orders.

Billing Information

Billing administrator name:

Please enter the full name of your billing administrator who manages your lab grants and contracts

Billing administrator email address:

Name of the grant that will be charged for your lentiviral requests:

The content of this field is kept private and will not be shown publicly.

Grant fund number:

Grant DPA number:

Grant end date:

You will need to see your PI or your Grants Administrator for the above information. It is important that this information is accurate or your order will not be processed. If you have any questions, please contact viracore@ucsf.edu

Biosafety Use Authorization

Enter your BUA number:

All users must provide their BUA number. The BUA must contain approval to work with Lentivirus. If you need help with this, contact viracore@ucsf.edu.

Credit card information

Card type:

i.e. Visa, Mastercard etc

Full name on card:

Expiration date:

Lab Information

Full name of the Principle Investigator: *

for example, Jonathan Smith.

Lab location: *

for example, HSW1057 - Parnassus Campus

Lab phone number: *

this is in case we need to contact you; enter the full number, ie. 123-4567