New Customer Application

1 Animal Welfare Information

Do you plan to order:

tissue collections, feces, TTCs, cryopreservation services

including Custom Model Generation and Colony Management Solutions
If you are planning to design or breed your animal model with Taconic, but have not yet selected a CRO for shipment of live animals, please select that you plan to order "Products" and your Taconic account will be setup without live animal shipment options until you have selected a CRO and provide Veterinarian contact information.

Does your company own/manage or outsource animal husbandry vivarium? *

Is the vivarium AAALAC accredited? *

Does the vivarium have a committee or ethical review process to ensure humane animal care and use: *

^*You are missing some required information above. See highlighted fields.

2 Company or Institution Information

Company or Institution Name *

Country *

Address Line 1 *

Address Line 2

City *

County/Region/Province

State *

Postal Code *

Type of Business *

Currency *

Financial Classification *

Contact First Name *

Contact Last Name *

Title *

Email *

Phone Number *

Fax

Preferred Method of Contact: *

Email

Fax

Telephone

Preferred Customer Service Location: *

US

EU

CN

Click the previous step title to review

^*You are missing some required information above. See highlighted fields.

3 Shipping Address Information

Is the Shipping information the same as the Company/Institution information?

Company or Institution *

Country *

Address Line 1 *

Address Line 2

City *

County/Region/Province

State *

Postal Code *

Shipping Contact First Name *

Shipping Contact Last Name *

Contact Title

Shipping Contact Email *

Shipping Contact Phone Number *

Shipping Contact Fax

Vivarium animal receiving hours of operation *

Special Delivery Instructions

Add an additional shipping contact? +-

Company or Institution

Country

Address Line 1

Address Line 2

City

County/Region/Province

State

Postal Code

Shipping Contact First Name

Shipping Contact Last Name

Shipping Contact Email

Shipping Contact Phone Number

Shipping Contact Fax

Click the previous step title to review

^*You are missing some required information above. See highlighted fields.

4 Billing Address Information

Is the Billing information the same as the Shipping information?

Is the Billing information the same as the Company/Institution information?

Company or Institution *

Country *

Address Line 1 *

Address Line 2

City *

County/Region/Province

State *

Postal Code *

Billing Contact First Name *

Billing Contact Last Name *

Contact Title

Billing Contact Email *

Billing Contact Phone Number *

Billing Contact Fax

Scandinavian EAN# *

Annual Estimated Purchasing $/€ *

Tax Exempt (US Only):

Yes

No

(If yes, please provide document as a pdf, txt, or doc file no greater than 5mb in size)

Invoice Distribution Method: *

Mail

Email

***Payment terms will be confirmed following review by Taconic's Finance Team***

Taconic needs the contact information you provide in this form to respond to your request.
For details please see our Privacy Policy.

^*You are missing some required information above. See highlighted fields.

Customs Broker Information

First Name *

Last Name *

Address Line 1 *

Address Line 2

City *

Province *

Postal Code *

Contact First Name *

Contact Last Name *

Contact Phone Number *

Contact Fax

Contact Email *

Comments

^*You are missing some required information above. See highlighted fields.

1 Animal Welfare Information

Special approval from Taconic Veterinary Science services is required to receive a live animal shipment. Contact Us here.

2 Company or Institution Information

3 Shipping Address Information

Is the Shipping information the same as the Company/Institution information?

Add an additional shipping contact? +-

4 Billing Address Information

Is the Billing information the same as the Shipping information?

Is the Billing information the same as the Company/Institution information?

Customs Broker Information

Special approval from Taconic Veterinary Science services is required to receive a live animal shipment.

Contact Us here.