2018-2019 School Year Mobile Lab Request

Please fill out all portions of this request form.  Once received YNS will contact you for shipment dates and details.  
Please complete all areas of the form for the lab(s) being requested.
Teacher Information
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(1) pGLO Mobile Lab Request

Please select the date you would like each lab. If you are not requesting the lab in the question, just leave the date blank. When selecting supplies from Nebraska EPSCoR, please only select the materials you need so we can get these materials to as many teachers as possible.

Used to send appropriate supplies amount
The following equipment is needed to complete the pGLO Mobile Lab, please select only the equipment you need from NE EPSCOR to complete the lab:







The following consumables are needed to complete the pGLO Mobile Lab, please select the materials you need Nebraska EPSCoR to provide:









(2) Restriction Enzyme Digestion and Analysis of Lambda DNA Mobile Lab Request
Used to send appropriate supplies amount
The following equipment is needed to complete the Restiction Enzyme Digestion mobile lab, please select only the equipment you need form NE EPSCOR to complete the lab.






The following consumables are needed to complete the Restriction Enzyme mobile lab, please select only the consumables you need NE EPSCoR to provide:












(3) PCR: Alu Insert on locus PV92 Chromosome 16 Mobile Lab Request
Used to send appropriate supplies amount
The following equipment is needed to complete the PCR: Alu Insert on locus PV92 Chromosome 16 Mobile Lab, please select only the equipment you need NE EPSCOR to provide







The following consumables are needed to complete the PCR: Alu Insert on locus PV92 Chromosome 16 Mobile Lab, please select only the consumables you need NE EPSCOR to provide









Demographics: Overall total of students participating in lab(s) selected?

Used for reporting purposes

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Mobile Lab Information
Have you ever used Nebraska EPSCoR Mobile Labs in the past?

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