Fax Quotation Form

Please print and fill out this form.Please fax completed form to: 888-670-0070 or 408-733-7603 (for international).

Date:	_________________________	City:	_________________________
Name:	_________________________	State,Zip:	_________________________
Company:	_________________________	Phone:	_________________________
Address:	_________________________	Fax:	_________________________

Peptide Sequence:

Alanine	Ala	A
Arginine	Arg	R
Asparagine	Asn	N
Aspatic Acid	Asp	D
Cysteine	Cys	C
Glutamic Acid	Glu	E
Glutamine	Gln	Q
Glycine	Gly	G
Histidine	His	H
Isoleucine	Ile	I
Leucine	Leu	L
Lysine	Lys	K
Methionine	Met	M
Phenylalanine	Phe	F
Proline	Pro	P
Serine	Ser	S
Theonine	Thr	T
Tryptophan	Trp	W
Tyrosine	Tyr	Y
Valine	Val	V

1	2	3	4	5	6	7	8	9	10
11	12	13	14	15	16	17	18	19	20
21	22	23	24	25	26	27	28	29	30
31	32	33	34	35	36	37	38	39	40
41	42	43	44	45	46	47	48	49	50

	Quantity:__________________________ Purity:_____________ Salt:________



	Instructions:_________________________________________________________