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User ID
User Password
Confirm Password
Title
First Name
Last Name
Role
Principal Investigator
Department
Institute
Address
City
Country
State
Zip Code
Telephone Number
Mobile Number
Fax Number
E-mail 1
E-Mail 2
E-Mail 3
Recommender's email
Channel to Macrogen
Priority
PO Number (VAT number)
Institute (for billing)
ATTN (name of person for billing)
Payment method
Invoice format
E-mail address for the
invoice and accountant
The same as E-Mail 1
When you use more than one e-mail address, please put a Comma(,) between mail addresses.
Telephone Number
of payer
The same as above Phone Number
Fax Number
of payer
The same as above Fax Number
Billing Address
The same as above Address