If you desire more than one strain, please complete a separate form for each of them Requestor Information Institution * Technion - Israel Institute of Technology Hebrew University of Jerusalem Weizmann Institute of Science Bar-Ilan University Tel Aviv University University of Haifa Ben-Gurion University of the Negev Ariel University Tel Aviv Sourasky Medical Center (Ichilov) Hadassah Medical Center Other Institution other * Principal Investigator Name * Cell Phone * E-mail * Is the PI the Contact Person? * Yes No Contact Person Name * Cell Phone * Contact Person E-mail * Ethical Approval Number of Research * PI's from other institutes- Please also attach a copy of the approval letter Upload - More informationFiles must be less than 2 MB. Allowed file types: gif jpg jpeg png html pdf doc docx ppt pptx. Budget to Charge: * invoice will be sent once the project has been agreed between the PI and the ABBM. Description of requested procedure Requested Procedure * Cryopreservation Sperm + IVF test Cryo-recovery Embryo Cryo-recovery Genotype Live stock rediveration Only Cryo preservation Sperm / Oocytes / Embryo Cryo recovery Oocytes Sperm Cryo-recovery +IVF Storage Cryo Import Live stock rederivation To generate pathogen free mouse lines, embryo is isolated from donor female and transferred to a clean recipient pseudo-pregnant female. Quantity and names of target genes * Please indicate where donor animals are currently being housed / will be coming from * Known pathogens to be cleared out to meet SPF1 standards? * Genetic background of embryos to be rederived * In case of multigenic/compound lines to be rederived: what is the estimated % of progeny of each potential genotype to be recovered? * Has the oocyte female donor line been tested for superovulation efficiency? * Yes No N/A Desired breeding scheme upon stock rederivation * Cryo-recovery Frozen sperm will be resuscitated by IVF and embryo transfer. Frozen embryos will be recovered and transplanted into pseudopregnant recipients. Sperm or embryos can be received frozen from other institutes. Cryo Sample IDs * Number of cryo samples being provided * Cryo-recovery of stocks preserved by external facilities * Please attach the detailed protocol that was used for cryopreservation and recommended cryo-recvery method More informationFiles must be less than 2 MB. Allowed file types: gif jpg jpeg png txt rtf html pdf doc docx ppt pptx xls xlsx. Upload Embryo Cryo-recovery Please indicate origin of cryo-stocks and current repository name * Sperm Cryo-recovery +IVF Please indicate the genetic background of oocyte donor female to be used * Storage Cryo Import You have chosen cryo preservation only, without an IVF recovery test. * Please confirm that you take full responsibility for all future cryo preservation recovery outcomes. Cryopreservation of either sperm or embryos enables you to save your colony in case of contamination and dramatically reduce costs associated with mouse colony maintenance, particularly of low use strains Strain Name * Name as will be printed on the straws, maximum 16 characters Background Strain * Quantity and names of target genes * Do you have a routine PCR (or other means) to check the required strain? * Please indicate the genetic background of oocyte donor female to be used. * Name of submitter * Submit
