HomeServicesOrder Order Order form Ethnic group*Please fill in the ethnic group you want to order from (only from the list above): Ashkenazi Ethiopian Georgian Iranian Iraqi Kuchin (India) Libyan Moroccan Sephardi (Turkey & Bulgaria ) Tunisian Yemenite Bedouin Druze PalestinianSample Type*Please fill in the sample typy you want to order (only from the list above): Frozen cells Growing cells DNA samplesQuantityGive a brief description for the research project for which the cell lines or DNA samples will be used:Agreement*I, the undersigned, state that: The requested cell lines/DNA samples will be used in my laboratory only for research. It is understood that the cell lines/DNA samples or their products will not be further distributed to other laboratories or any scientists. No change will be made in scientific publications in the individual numbers of the cell lines or DNA samples. Human cell lines/DNA samples may carry viruses, viral genes or other hidden contagious factors. I shall therefore take all the necessary steps to protect myself and my laboratory personnel who will handle these cells/DNA samples. It is understood that The National Laboratory for the Genetics of Israeli Populations, and/or Tel-Aviv University and/or researchers who contributed the cell lines to the National Laboratory's collection and/or the researcher institute in which these cell lines were originally prepared, will not be held responsible for any risks associated with these human cell lines/DNA samples. I shall pay for the cell lines/DNA samples according to the price list of The National Laboratory for the Genetics of Israeli Populations. I Accept Name* Dr.Prof.Student Prefix First Last Email* Phone*Shipping Address:*Billing Address:*PhoneThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.