Account setup for JAX Mice and Services customers

*2. Please indicate which items the End-User Organization will be using (check all that apply):

*5. Are you using JAX^® Mice to provide products or services to another organization?

8. The Jackson Laboratory rigorously excludes a wide range of pathogenic viruses, bacteria, parasites, and other organisms (please see our list of agents monitored for details). However, a few opportunistic organisms are tolerated in some areas, particularly within our Research facility. If you have any restrictions regarding the importation of mice harboring opportunistic microorganisms, please explain:

*9. Please provide information about the Veterinarian who will be responsible for animal care and welfare oversight:

*Designates required information

10. How do you intend to import mice shipped from The Jackson Laboratory to destinations outside of the USA?

NOTE: International customers using Charles River Laboratories or i-DNA Biotechnology Pte Ltd. do NOT need to complete a credit application.

Agreement to Conditions of Use and General Terms

"MICE" means mouse strains, their progeny derived by inbreeding or crossbreeding, unmodified derivatives from mouse strains or their progeny supplied by The Jackson Laboratory ("JACKSON"). "PRODUCTS" means biological materials supplied by JACKSON, and their derivatives. "RECIPIENT" means each recipient of MICE, PRODUCTS, or services provided by JACKSON including each institution, its employees and other researchers under its control. MICE or PRODUCTS shall not be: (i) used for any purpose other than the internal research, (ii) sold or otherwise provided to any third party for any use, or (iii) provided to any agent or other third party to provide breeding or other services. Acceptance of MICE or PRODUCTS from JACKSON shall be deemed as agreement by RECIPIENT to these conditions, and departure from these conditions requires JACKSON's prior written authorization.

No Warranty
MICE, PRODUCTS AND SERVICES ARE PROVIDED "AS IS". JACKSON EXTENDS NO WARRANTIES OF ANY KIND, EITHER EXPRESS, IMPLIED, OR STATUTORY, WITH RESPECT TO MICE, PRODUCTS OR SERVICES, INCLUDING ANY IMPLIED WARRANTY OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, OR ANY WARRANTY OF NON-INFRINGEMENT OF ANY PATENT, TRADEMARK, OR OTHER INTELLECTUAL PROPERTY RIGHTS.

In case of dissatisfaction for a valid reason and claimed in writing by a purchaser within ninety (90) days of receipt of mice, products or services, JACKSON will, at its option, provide credit or replacement for the mice or product received or the services provided.

* I agree to the above "Conditions of use and General Terms" and attest that the information submitted in this form is accurate and true.

Please include the name or title of the position of the person agreeing to these "Conditions of Use and General Terms." This person should hold a position of authority within the organization

Please select one of the following if the shipping organization is different than the billing organization:

I have requested the following shipping organization submit a new customer application:
I am completing this application at the request of the following billing institution, or I have requested the following billing institution submitted a new customer and credit application:
Shipping and billing organizations are the same on this application

Payment information

Please select one of the following:

I would like to be invoiced for payment after my order ships, or would like to use a Purchase Order.
(Terms of this option are determined by The Jackson Laboratory finance department)
I would like to use a Credit Card
I would like to Prepay

Required

Credit application (.pdf) is required to be submitted in addition to this form (please see exceptions below).
Please indicate the date which the credit application was or will be submitted by fax:

Exception: International customers using Charles River Laboratories or i-DNA Biotechnology Pte Ltd. do NOT need to complete a credit application. (This should be noted in item 10 above)

Please indicate the following:
	I am completing a domestic application for orders to be shipped within the United States
	I am completing an international application for orders to be shipped outside the United States

Purchasing Contact Information
*Email:
Salutation:	Dr. Ms. Mr. Prof.
*First name:
Middle name:
*Last name:
*Position/Title:
*Phone:
*Fax:

End-User Contact Information End-User is the person using JAX^® Mice & Services.
Same as purchasing information
*Email:
Salutation:	Dr. Ms. Mr. Prof.
*First name:
Middle name:
*Last Name:
*Position/Title:
*Phone:
*Fax:
Organization website:

Billing Information
*Organization type:	For profit For profit contract research organization Not-for-profit [Tax Exempt ID: ] Other [please specify: ]
*Organization name:
Department/Mail stop:
*Address:

*City:
*State/Province:
*Country:
*Zip/Postal code:

Shipping Information If mice are being shipped to an organization other than the billing organization listed above, the organization receiving the mice must also submit a customer application.
Same as Billing Information
*Organization type:	For profit For profit contract research organization Not-for-profit [Tax Exempt ID: ] Other [please specify: ]
*Organization name:
Department/Mail stop:
*Address:

*City:
*State/Province:
*Country:
*Zip/Postal code:

*Email:
*Name:
*Qualification:	DVM Other
*Address:
License No.
*Phone:
Fax:

The Jackson Laboratory

Shortcuts for researchers

Establish an account to order JAX® Mice & Services

Purchasing Contact Information

End-User Contact Information

Billing Information

Shipping Information

Product Use Information

Agreement to Conditions of Use and General Terms

Payment information

Required

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