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JOB # M.D. Anderson Cancer Center Genetically Engineered Mouse Facility IN VITRO FERTILIZATION-OUTSIDE PI SERVICE REQUEST FORM REV 2/12 Date: Name: PI: PO #: Complete Billing Address: Animal Protocol
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C57BL/6J.1 or C57BL/6J.2? What is the type of animal used in the study? What is the animal identification number or (an “I” number) of the animal used? What are the origins of the animals? Name of the investigator(s) or investigator(s) sponsoring the study. The investigator is offering an unrestricted, unrestricted, open source, non-profit, worldwide license of the strain used to produce the mice to researchers who have already applied to use the animals in research for purposes allowed by an approved IRB-approved protocol. The investigator will be responsible for paying the animal protocols, research travel allowances, fees for the animal facility (if applicable), handling, maintenance, and other expenses associated with animal use. The animal facilities will be rented, at the participant's expense, for the duration of the study. How likely is your participation in using these mice to influence your conclusions regarding the safety or effectiveness of cannabinoid receptor agonists in humans? Is there a difference between this strain of C57BL/6J mice and any other strain of C57BL/6J mice, like C57BL/6J mice that originate from other sources? I understand there is a 150 charge to each individual in order to cover the cost of shipping. If you are participating outside North America, if you are interested in participating without paying any shipping costs, please contact the GEM. We will try to get you one of the mice when it arrives from the G-7 Lab to replace the one you are replacing, or you can send us the original, unblemished mice of the strain you are currently using. Please use the G-7 name as the donor's name and the recipient's initials as the recipient's name. Name of the recipient. Name of the donor. I understand this research has the possibility of creating a product that may result in the use of chemicals, chemicals, chemicals, or chemicals. Please tell me if I can donate to the G-7 Lab using products I am willing to sell to my own lab. I understand donating to this project is voluntary, and I am willing to donate. If I am willing to sell my products, please tell me in order to provide me with a link to my product list on this site for listing. I understand there is a charge of 250 to cover the costs of shipping to my lab. I understand the G-7 Lab has not yet received payment for my fee for shipping the mice.

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