Principal Investigator Title* --select-- Dr. Miss Mr. Ms. Prof. First Name* Middle Last Name* Job Title* Degree Organization* Addr Line 1* Addr Line 2 Addr Line 3 Addr Line 4 City* State/ Prov* Country* Postal Code* Phone* Fax E-mail* Shipping Address (if different from above) Note: We are unable to ship to P.O. boxes. Investigators in Australia and New Zealand click here. Addr Line 1 Addr Line 2 Addr Line 3 Addr Line 4 City State/ Prov Country Postal Code Courier Service Name Acct. No. Secondary Investigator, if applicable Title --select-- Dr. Miss Mr. Ms. Prof. First Name Middle Last Name Title Degree Organization Addr Line 1 Addr Line 2 Addr Line 3 Addr Line 4 City State/ Prov Country Postal Code Phone Fax E-mail Contract and Grants Officer Title* --select-- Dr. Miss Mr. Ms. Prof. First Name* Middle Last Name* Title* Organization* Addr Line 1* Addr Line 2 Addr Line 3 Addr Line 4 City* State/ Prov* Country* Postal Code* Phone* Fax E-mail* Material Requested Material* Quantity* Material Quantity Material Quantity Material Quantity Material Quantity Material Quantity Amgen Contact Name of Contact Research Interest Title of Research* Research Protocol* (Please limit your text to 4000 characters) Interest Topics* Adjuvants Angiogenesis Animal Models Antigen Presentation Asthma/Allergy Autoimmunity B cell Biology Bone Biology CAR Cardiac Biology Cell Adhesion Cell Death Cell Migration Chemokines Chemotherapy Cytokine Induction Dendritic Cell Biology Ex Vivo Gastrointestinal Biology Gene Therapy Genetic Disorders HIF HIV/SIV/AIDS Models Hematology Hematopoiesis Hemostasis Hypersensitivity Immunodeficiency Immunology In Situ In Vitro In Vivo Infectious Disease Inflammation Joint Biology Macrophage/PMN Biol. NK cell Biology Nephrology Neurobiology Oncology Pathology Periodontal Disease Pharmaceutics Pharmacology/Tox Proteases Reproductive Biology Respiratory Biology Signal Transduction Skin Biology T cell Biology Tissue Growth Tolerance Toxicology Transplantation Tumor Drug Resistance Tumor Immunology Vascular Biology Virology Other (please specify) Model List Mouse Rat Other (please specify) Provide the following for in vivo studies: Species Amount per Dose No. of Doses No. of Animals Total amount needed