NEXT GENERATION SEQUENCING SAMPLE SUBMISSION
                                                  FORM
                                      ΙΜΒΒ-Genomics Facility
                          Institute of Molecular Biology & Biotechnology IMBB
                             Foundation for Research & Technology - Hellas
                       Nikolaou Plastira 100 GR-70013, Heraklion, Crete GREECE
                                            st
                                          1  Floor, Room A-206
                                             Tel: 2810 391150
              website: https://www.imbb.forth.gr/imbb-people/en/genomics-facility-home
                                 email: genomics.facility@imbb.forth.gr
               Please fill in this form and submit it via email prior to sample submission.
                   Information about the project/samples and the requested service should
                   be discussed in advance with the facility personnel. To arrange a
                   meeting please email or call us.
             User Name:                                PI   Name:
                      Email:                                 Email:
                Tel. num.:                             Tel. num.:
             Institution:                              IMBB member: 
                                                          YES       NO
                                                       Date: 
             Charge service:
                 Issue Invoice to:
             Entity:
             Address:
             Tax Registry Number:
             Internal Revenue Service office:
             Grant/program number:
             Accounting Dept. phone number:
                Charge IMBB Program Number:
                      NEXT GENERATION SEQUENCING SAMPLE SUBMISSION FORM
                   Cover cost by providing consumables:
               SAMPLE INFORMATION
               Species: ______________
               Samples:
                   gDNA        Total RNA        Small RNA          mRNA   ChIP   
               Other:_____________
               Concentration prior to submission estimated by: 
                     Nanodrop          Qubit          Bioanalyzer        Pico Green          None 
               Other:_________________________ 
               Requested Services:
               Sample quality and quantity control:
                    Bioanalyzer         Qubit        None
               Library construction:
                    RNA-seq           ChIP-seq          DNA-seq              Exome         Ampliseq         
               16S 
               Details about the protocol to be used (e.g. Full RNA-seq or 3’ Quant):
               Sequencing:
                    NextSeq500 
                      Read length (bp):          1x75 
                             no of reads:        1M      10M       20M        40M          other_______
                      Read length (bp):          2x150 
                             no of reads:        1M      10M       20M        40M          other_______
                                                             2
              NEXT GENERATION SEQUENCING SAMPLE SUBMISSION FORM
                    Other flowcell type:_______________
                                     3
                  NEXT GENERATION SEQUENCING SAMPLE SUBMISSION FORM
          Sample      Original     Conc.    Volume      Condition/type (e.g.      Million
            ID        Sample       (ng/μ     (μL)      control or treatment)      reads
                       Name          L)                                         requested
             1      e.g. wt1       37      20         Wild type, brain         30
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            Please label your tubes clearly only with the Sample ID on both the lid and
            on the side.
            Additional comments: 
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