Conservation Genome Resource Bank for Korean Wildlife

Bldg #85-906, College of Veterinary Medicine, Seoul National University

San 56-1 Shillim-9-dong, Gwanak-gu, Seoul 151-742, South Korea

Tel: +82-2-888-2744; Fax : +82-2-888- 2754; URL: http://www.cgrb.orgE-mail : cgrb@cgrb.org

Receipt No.
Receipt Date
Member No.

Application for Genetic Resource Sample Distribution

Name
Position
Address				Zip code
Tel		Fax
Cellphone
E-mail

No.	ID	Species Name	Resource Name(Tissue)	Quantity	Remarks
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7
Brief Description of the Project for these Sample
Indicatio	Please acknowledge CGRB as the source of the samples when you publish the results from those samples provided by CGRB and send a reprint of the publication to CGRB

□  Do not fill in the Receipt No., Receipt Date, Member No.

Date :

Applicant	(Signature)

Conservation Genome Resource Bank for Korean Wildlife