STATEMENT OF RESEARCH INTENT
For each research project submit separate Statements of Research Intent.
Please fill out all parts of the form. Use additional sheets as necessary.
Date:
Part I: List the Repository number for each DNA sample, or DNA Panel you wish to
order:
Repository Number
Description (please include species)
Part II: Select one which best describes your research intent:
Determine the ancestral state of a polymorphism/haplotype
Determine the structure/function of individual genes
Compare the presence/absence of specific genes across species
Identify conserved regulatory elements
Characterize human-specific features
Look for evidence of natural selection on DNA sequences
Compare repetitive elements across species
Compare sequences, i.e., examine molecular phylogenies
Other (please specify)
Part III: Please describe more specifically the study or studies you will conduct using
these samples. (You may type and attach the description, or include a copy of the
abstract of your research grant that describes the project).
Part IV: Please provide some additional information.
Will the research benefit conservation?
Yes
No
If Yes, please specify
Will the sample(s) be used for educational purposes?
Yes
No
If Yes, please specify
Part V: Contact information.
Please provide the e-mail address of the scientist directly responsible for the use of the cell
culture or DNA sample.
Name:
Institution:
e-mail:
Signed:
To contact the Integrated Primate Biomaterials and Information Resource
Write: CORIELL CELL REPOSITORIES
403 Haddon Avenue; Camden
New Jersey 08103; USA
Call:
800-752-3805 in the United States; 856-757-4848 from other countries
Fax:
856-757-9737
e-mail: [email protected]
Version 2, February 10, 2004