Online Order Form

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Use this form to order up to five sequences. Large orders can be completed by sending information on multiple forms. If you have any problems with this form, you may send the information by E-mail to info@genemedsyn.com or call 1-800-344-5337.

Your Name:   
Company:   
Shipping Address:  
City, State, Zip:  
Telephone:    (Required)
Fax:  
E-mail:  
Billing Address:  
City, State, Zip:  
Purchase Order:

Payment Method:

    
P.O./Card Number:  
Expiration Date:   
 
 
Sequence #1
Type: DNA  Peptide
Sequence name: Length:
DNA scale of synthesis:
Peptide scale of synthesis:
Other scale: Please call 800-344-5337
Purification code: (DNA codes) (Peptide codes)
Modifications: (DNA codes) (Peptide codes)
Labeling: (DNA codes) (Peptide codes)
Conjugation: (DNA codes) (Peptide codes)
Other code no.: (DNA codes) (Peptide codes)
Sequence: (5' to 3' for DNA) (NH2 to COOH for Peptides)
Note: Max. 50 bases per line


  Codes for Mixed Base

OR complete another sequence below.

Sequence #2
Type: DNA  Peptide
Sequence name: Length:
DNA scale of synthesis:
Peptide scale of synthesis:
Other scale: Please call 800-344-5337
Purification code: (DNA codes) (Peptide codes)
Modifications: (DNA codes) (Peptide codes)
Labeling: (DNA codes) (Peptide codes)
Conjugation: (DNA codes) (Peptide codes)
Other code no.: (DNA codes) (Peptide codes)
Sequence: (5' to 3' for DNA) (NH2 to COOH for Peptides)
Note: Max. 50 bases per line


    Codes for Mixed Base AA Codes for Peptides


OR complete another sequence below.

Sequence #3
Type: DNA  Peptide
Sequence name: Length:
DNA scale of synthesis:
Peptide scale of synthesis:
Other scale: Please call 800-344-5337
Purification code: (DNA codes) (Peptide codes)
Modifications: (DNA codes) (Peptide codes)
Labeling: (DNA codes) (Peptide codes)
Conjugation: (DNA codes) (Peptide codes)
Other code no.: (DNA codes) (Peptide codes)
Sequence: (5' to 3' for DNA) (NH2 to COOH for Peptides)
Note: Max. 50 bases per line


    Codes for Mixed Base AA Codes for Peptides


OR complete another sequence below.

 

Sequence #4
Type: DNA  Peptide
Sequence name: Length:
DNA scale of synthesis:
Peptide scale of synthesis:
Other scale: Please call 800-344-5337
Purification code: (DNA codes) (Peptide codes)
Modifications: (DNA codes) (Peptide codes)
Labeling: (DNA codes) (Peptide codes)
Conjugation: (DNA codes) (Peptide codes)
Other code no.: (DNA codes) (Peptide codes)
Sequence: (5' to 3' for DNA) (NH2 to COOH for Peptides)
Note: Max. 50 bases per line


    Codes for Mixed Base AA Codes for Peptides


OR complete another sequence below.

Sequence #5
Type: DNA  Peptide
Sequence name: Length:
DNA scale of synthesis:
Peptide scale of synthesis:
Other scale: Please call 800-344-5337
Purification code: (DNA codes) (Peptide codes)
Modifications: (DNA codes) (Peptide codes)
Labeling: (DNA codes) (Peptide codes)
Conjugation: (DNA codes) (Peptide codes)
Other code no.: (DNA codes) (Peptide codes)
Sequence: (5' to 3' for DNA) (NH2 to COOH for Peptides)
Note: Max. 50 bases per line


    Codes for Mixed Base AA Codes for Peptides

Genemed Synthesis Inc.
Complete our on-line order form

6203 Woodlake Center Dr. Bldg 2
San Antonio, TX 78244 USA
E-mail: info@genemedsyn.com Toll-free: 1-800-344-5337
Phone: 210-745-5988 Fax: 210-745-5992
Web Site: http://www.genemedsyn.com

Genemed Synthesis Inc

Please note our Address has changed!!!