Account Registration

Welcome to the registration page for new users. *Required

Principal Investigator
Name*
First Last
Department/College
Email*
Phone
PO Box
Fiscal Assistant
Name*
First Last
Email*
Phone
Lab Submitters
Staff approved to submit samples for my lab:
First Name Last Name Email Phone
FedEx Shipping Information
Only for those who need samples returned by FedEx. When account information left blank, regular MPC costs apply.
FedEx Account information
Ship to:
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
FAX (required by FedEx)
Lab contact cell phone number

Required by FedEx in case of delivery issues
Comments or additional information
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Molecular Pathology Core

First Name	Last Name	Email	Phone