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PI Name *
PI Email *
Contact Name *
Contact Email *
Other Contact Name
Other Contact Email
Institution and Department *
Billing Name *
Billing Email *
Billing Phone *
Penn applicants: enter both Mail Code and COA below. Penn affiliates, enter Billing Address only.
UPenn Mail Code (for Penn applicant)
26 digit COA (for Penn applicant) (example: 333-4444-1-666666-4444-4444-4444)	- - - - - -
	OR
Billing Address (for Penn affiliate (such as CHOP, Wistar etc.))
Software Needed *	Transcript Profiling Tools - GeneSpring (one concurrent use): $1200/lab/year.
	Sequence Analysis Tools - Discovery Studio Gene (Windows), MacVector (Mac), Sequencher (Windows or Mac), Lasergene (Windows or Mac). Cost: $300/lab/year for two computers plus $50/lab/year for each additional computer.
The number of computers is the total number of licenses required: for the Sequence Tools it is the total number of computers, and for Genespring it is the number of concurrent licenses.
Number of computers *
For GeneSpring, please list the IP addresses of the computers on which you will install this software. Do not include home computers in either the number of computers or the list of IP addresses.   For the Sequence Analysis Tools, please list the MAC addresses of the computers on which you will install this software. Include both the airport address and ethernet address for laptops that have both wireless and ethernet interfaces and indicate this in the comments.
Find MAC addresses on a Windows machine	Find MAC addresses on a Macintosh (Mac OS X) machine
IP Addresses / MAC addresses (separate by space)*
Check if using HUP Net
Comments Please indicate in the comments if you are transferring a standalone license(s).