We appreciate your interest in the new E-Gel® Go! system. Please complete the following information and answer a few questions for us, so we can better understand your needs.

Contact Information

*
*
*
 
 
*
*

Mailing Address

*
 
 
 
 
*
*
*

Job Role

 CEO / COO / President
 Vice President
 Department Head
 Principal Investigator
 Medical Doctor
 Director
 Post-doctoral fellow
 Scientist / Associate Scientist
 Student / Graduate Student
 Research Assistant / Lab Technician
 Lab Manager
 Purchaser / Procurer
 Educator
 
 

I would use this system to run: *

 1% gels
 2% gels
 Both 1% and 2% gels

My primary application for using this gel electrophoresis system would be to do a quick check of: *

 PCR reactions
 Restriction digests
 Other
 

How many gels do you currently use, on average? *

 Less than one a week
 1 - 5 per week
 6 - 10 per week
 11 - 25 per week
 More than 25 per week

What type of gels do you most frequently use today? *

 I pour my own
 A lab manager/technician pours for the lab
 I purchase precast gels

I am interested in purchasing a new gel electrophoresis system in: *

 0 - 1 months
 2 - 4 months
 5+ months
 No purchase plans
 
 

If you are not the Principle Investigator of your lab, please provide the name of your PI: