1 Start 2 Complete Please note -All the details below will be used to organize the official papers and you cannot change them without updating the coordinator.When the shipment is approved, shipping date will be coordinated by the Import-Export coordinator. Principal Investigator PI Name * PI Department * PI Phone * PI Cell Phone * PI Email * Contact Person Contact Name * Contact Phone * Contact Cell Phone * Contact Email * Billing * For estimated charges (export, boxes for shipment etc.), please contact the ABBM office - 88465. Please choose one of the following options for billing * Charge the budget from the Animal Facility system. Charge the budget from this form. Charge the recipient * please note that there will be also an administration fee charge. Please note that if the recipient will not pay within 45 days, your budget will be charged automatically. Collaborating Principal Investigator Collaborating PI Full Address * Collaborating PI name * Collaborating PI Phone * Collaborationg PI Email * Collaborating Contact Person Collaborating Contact Name * Collborating Phone * Collaborating Contact Email * Description of Animals from which the semen originated Please fill in the chart with the specific characteristics per each similar group of mice. Strain / Line * Background (If the strain is Tg, KO etc.) * Color * + Add another animal type add animal type * Description of Animals from which the semen originated 2 Strain / Line * Background (If the strain is Tg, KO etc.) * Color * Total number of strows * Location (Facility) where the mice were kept (Unit and room #) * Comments * Principal Investigator (in the Hebrew University) Signature Name as electronic signature * Date * Day12345678910111213141516171819202122232425262728293031 Day MonthJanFebMarAprMayJunJulAugSepOctNovDec Month Year20222023202420252026 Year Submit
