Gene Expression Analysis Service 
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                            Please complete this form and email to us (orders@lcsciences.com) prior to sending your samples.
                            [Part 1 – Contact Information]
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                            [Part 2 – Payment Information]
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                            [Part 3 – Sample/Array Information]
                                                                               Sample Type               Sample Source                                            Extraction
                                Sample                                            (Total RNA,              (Tissue or Cell               Array Part               Method (if                  Sample                   Quantity                  Conc.               Amplification
                                Number              Sample Name mRNA, cells, etc.)                                Line)                    Number                   applies)                 Solution                     (µg)                   (µg/µl)                Required
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                                                                                                                                  © 2011 LC Sciences LLC CF-30-07B
                 [Part 4 – Data Analysis Request Information]
                 In the space below please describe, in general terms, the comparisons you would like to make.
                                                                                                                                                                                                                                                                               
                 1.   Test Type: select t-Test or ANOVA
                 2.   Test No.: use sequential number, such as t-Test-01, t-Test-02, etc.
                 3.   Test Name: use a short and proper name, such as wt vs mutant
                 4.   Group No.: use 1 and 2 to define the two groups of samples to be compared in t-Test; use sequential number in ANOVA
                 5.   Group Name: use short and proper names, such as control, wildtype, mutant, etc.
                 6.   Sample Name: select a sample name from your list of samples.
                 7.   Pairing: if a paired t-Test is required, mark the paired samples with the same number.  Otherwise leave the cell blank.
                 8.   Comment: when needed, write special requests
                                                                                    Group
                  Test Type       Test No.      Test Name        Group No.          Name      Sample Name        Pairing                      Comment