Animal Resources - Animal Ordering Form

Complete the information below to place an animal order request.

Principal Investigator Information
Name Name First Last
Principal Investigator Email
ACUP #
ACUP Title
Alternate Contact Information
Name Name First Last
Alternate Contact Email
Order Details
Expected Date of Delivery Expected Date of Delivery / MM / DD YYYY
Preferred Vendor/Source
Please include : species, breed/stock/strain, #males, #females, and purchase/transfer ==============================
Please include: species, breed/stock/strain, #males, #females, and purchase/transfer
Billing Account #
Requested Housing Location
Duration of Housing
Who will purchase the listed animals?
Age or weight range of animals
Special needs/requests from vendor (surgical modification, age, or weight critical, etc.)
Special requests from Animal Resources (aseptic caging, special diets, RO water, individual housing, etc.)

Please ensure special requests are also included in the approved ACUP.
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