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Quotation Request for Custom Peptide Synthesis

 
Please complete this formulary and we will contact you as soon as possible.
If Covalab does not contact you few days after sending this formulary it is because of a technical problem during the sending of the formulary. If so, thank to try again or to contact us.
 
Because of technical problem, formulary send before 08/15/2007 could not be processed. Sorry for the inconvenience.
 
Civility: Mr Mrs Miss
Fullname:
Company/Site:
Unit:
Laboratory:
Building/stages:
Address:
Postal code/ZIP: City:
Country:
Phone:
email:*
  • Peptide Information:

 

Peptide name:

 

Purity: >70% >80% >95% Other: %
 
Quantity: mg - Number of amino acids: AA

 
Sequence:
 

N C

Please enter the code sequence with one letter from N-ter to C-ter.

For Naural AA (L), use capital letter.

For Un-natural AA (D), use lower case letter.

A - Ala R - Arg D - Asp C - Cys Q - Gln E - Glu G- Gly H - His I - Ile L - Leu K - Lys  
M - Met F - Phe P - Pro S - Ser T - Thr W - Trp Y - Tyr V - Val        
 

Your message: (either in French or in English)

 

 
If you have any problem to complete this formulary, do no hesitate to inform our webmaster or to contact us.
 

Les informations recueillies font l’objet d’un traitement informatique destiné à pouvoir traiter vos remarques. Le destinataire des données est Covalab. Conformément à la loi «informatique et libertés» du 6 janvier 1978, vous bénéficiez d’un droit d’accès et de rectification aux informations qui vous concernent. Si vous souhaitez exercer ce droit et obtenir communication des informations vous concernant, veuillez nous contacter par email: enquiries@covalab.com Vous êtes susceptibles de recevoir des offres commerciales de notre société. Si vous ne le souhaitez pas, cochez la case ci-contre Covalab s'engage à ne transmettre aucune information vous concernant. La personne complétant ce formulaire est tenue seule responsable des informations transmises. Covalab s'engage à répondre à toutes demande d'information par ce formulaire à condition qu'au minimum le champ email soit correctement renseigné, que la demande soit explicite.et hors problème technique indépendant de Covalab.

Data protection statement: Information supplied will be held securely and confidentially on the Covalab's data base in accordance with the French data protection law act (01/06/1978). Data is used to answer to your demand. Any information will be treated confidentially and will not be disclosed to external organisations other than Covalab and agents acting for Covalab. You have a right of view and of modification about your information, if you wish so, please email to enquiries@covalab.com. We use the information we collect to provide the services you request. Our services may include the display of personalized content and advertising. If you do not wish to receive adverts please untick the previous case (in the french part). Your demand we will be treated as soon as possible provided that the formulary is completedcorrectly (at least a correct email address). If Covalab does not contact you few days after sending this formulary it is because of a technical problem during the sending of the formulary. Then, please try again or contact us. It is your responsibility to ensure that the request is clearly formulated.

 
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