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All fields are required unless specified “optional”. Please provide as much information as available in each case.

Chemicals which are not commercially available should not be described. In this case check “Not Commercially Available” below and complete only the fields listed under “Contact Information”. These submissions will not be queued until a confidentiality agreement is in place.

Contact Information
  1. Mailing Address
Description of Chemical Entity
  1. Toxicity and Safety

    Please describe any known toxicity information and safety precautions

  2. Quantitative Measurement

    Please desribe available analytical procedures for quantitative measurement of chemical entities

Delivery Parameters
Collaboration Guidelines

Please describe the level of scientific collaboration envisioned

    1. Time Requirements