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Ambystoma Genetic Stock Center Online Order Form

Must be submitted at least one week prior to shipping date (for all animal orders).
*Price list should be reviewed for most recent prices (Price List)

**Online Form Submission is UNDER MAINTENANCE**
Please use this downloadable PDF form and email us the completed form to submit your order.  Thank you!

Contact Name :
Name of Principle Investigator (if applicable):
Date When Material is Needed:
Registration Completed? Yes No
Size Range:
* Phenotypes Available: wild-type, normal, white, albino, melanoid
* Mutations Available: cardiac, short-toe, eyeless
* Transgenics Available:

embryos ($55-$100/100) Qty:
      Please provide Phenotype and Mutation:
hatchlings ($0.55-$1.50/ea) Qty:
Please provide Phenotype and Mutation:
2-3 cm larvae ($1.00-$2.00/ea) Qty:
     Please provide Phenotype and Mutation:
3-5 cm larvae ($3.00-$6.00/ea) Qty:
     Please provide Phenotype and Mutation:
5-8 cm juveniles ($9.50-$20.00/ea) Qty:
     Please provide Phenotype and Mutation:
8-12 cm juveniles ($13.50-$30.00/ea) Qty:
     Please provide Phenotype and Mutation:
sub-adults ($17.50-$36.00/ea) Qty:
    Please provide Phenotype and Mutation:
adults ($25.00-$60.00/ea) Qty:
    Please provide Sex, Phenotype and Mutation:


Pellets ($5.50/bag): Small (1/2 lb bag) Qty: Large (1/2 lb bag) Qty:
Brine shrimp eggs ($5.50/1 oz. vial) Qty:
Holtfreter's salts - makes 40% solution in 40 gallons of water ($6.00/bag) Qty:
Bowls ($4.00/ea): Small   Qty: Large   Qty:
De-chlorinator (AmQuel) - 2 oz ($4.50) Qty:
Skin conditioner (NovAqua) - 2 oz ($4.50) Qty:
Axolotl Newsletter Archive CDs (set of 3; $60.00) Qty:

Educational Supplies:
Larvae kit ($35.00/ea; 3 pellet-eating larvae, water treatment, food, and ruler) Qty:
Embryo kit ($30.00; 30 unsorted eggs, water trtmt, food, petri dishes, pipettes, ruler) Qty:
Eggs only ($16.50/30 unsorted eggs) Qty:
Larvae only ($28.50/3 pellet-eating larvae) Qty:
Brine shrimp hatchery ($35.00/ea) Qty:
Axolotl Materials & Images CD ($10.00/ea; for teachers) Qty:

Payment Method: PO - PO Number: Check Credit Card (MasterCard, VISA, AMEX, Discover)

NOTICE 1: There is a $5.00 - $10.00 handling fee on all boxes that contain live materials.

NOTICE 2: There is a minimum order total of $30.00 for all credit card orders.

GENERAL SHIIPING FEES (on all non-animal orders):
If your merchandise total is...                         Then your shipping costs will be:

Between $4.00 - $35.00                                  $9.00
Between $36.00 - $60.00                                $12.00
Over $60.00                                                    e-mail for estimate
Newsletter Archive CDs ONLY                       $10.00

All shipments containing LIVE animals are shipped OVERNIGHT, thus exact shipping prices cannot be determined until the package is ready to be shipped.

Contact information, if you have not registered:

Shipping Address:

Phone Number:
E-mail Address: