HomeAnimal & Veterinary ServicesAnimal Order Form Animal Order Form PROTOCOL INFORMATION PI First Name PI Last Name Department IACUC Protocol Number IBC Protocol Number if ordering IBC covered strains or "N/A" PI phone PI fax PI email ORDER CONTACT INFORMATION First name Last name Phone Fax Email FISCAL ADMINISTRATOR INFORMATION FA code (optional) FA first name FA last name FA phone FA email ANIMAL ORDER 1 Number of animals Vendor Species Strain *to avoid delays, use the exact strain nomenclature that appears on your approved IACUC/IBC protocols Vendor stock number Is this strain a transgenic or knockout? SelectYesNo Gender SelectMaleFemaleEither Weight/Age of animals Facility SelectKakaakoManoa Number of animals per cage Requested arrival week (please select the Monday of desired week) mm/dd/yyyy Special requirements ANIMAL ORDER 2 ANIMAL ORDER 2 Number of animals Vendor Species Strain *to avoid delays, use the exact strain nomenclature that appears on your approved IACUC/IBC protocols Vendor stock number Is this strain a transgenic or knockout? SelectYesNo Gender SelectMaleFemaleEither Weight/Age of animals Facility SelectKakaakoManoa Number of animals per cage Requested arrival week (please select the Monday of desired week) mm/dd/yyyy Special requirements ANIMAL ORDER 3 ANIMAL ORDER 3 Number of animals Vendor Species Strain *to avoid delays, use the exact strain nomenclature that appears on your approved IACUC/IBC protocols Vendor stock number Is this strain a transgenic or knockout? SelectYesNo Gender SelectMaleFemaleEither Weight/Age of animals Facility SelectKakaakoManoa Number of animals per cage Requested arrival week (please select the Monday of desired week) mm/dd/yyyy Special requirements ANIMAL ORDER 4 ANIMAL ORDER 4 Number of animals Vendor Species Strain *to avoid delays, use the exact strain nomenclature that appears on your approved IACUC/IBC protocols Vendor stock number Is this strain a transgenic or knockout? SelectYesNo Gender SelectMaleFemaleEither Weight/Age of animals Facility SelectKakaakoManoa Number of animals per cage Requested arrival week (please select the Monday of desired week) mm/dd/yyyy Special requirements I certify that I am aware of the AVS Fiscal Office deadline for placing orders and the policy on scheduling deliveries for holiday weeks as stated on the AVS website. I am also aware and acknowledge that by placing the order, AVS will be charging an animal order fee. I confirm that I have reviewed this form for completeness and accuracy.
