UTEX Discount Request Application Form

IMPORTANT: United States Non-Profit Academic & Government Institutions, and Affiliated Teachers/Students within the contiguous U.S. are eligible to apply for the discounted rate on Living Algal Strains. While a UTEX Customer Account is not required to make a regular purchase, customers who are requesting the discounted rate must have an account set up prior to approval. If you are using a different email to submit this form than the one used for the Customer Account, please make sure to provide the UTEX Customer Account email where requested.

Full Name*

First NameLast Name

Do you currently reside in the contiguous United States of America?*

We're sorry! Due to the terms of our NSF grant, the discount is only available to other US Non-Profit Academic and Government Institutions located within the contiguous United States.

Return to Account

Are you affiliated with a United States Non-Profit Academic University/College or Government Institution?

Are you a United States Academic K-12 Student or Teacher?

We're sorry! Due to the terms of our NSF grant, the discount is only available to other United States Non-Profit Academic and Government Institutions within the US.

Return to Account

E-mail Address

Confirmation EmailShould end with '.edu' or '.gov'

E-mail used for UTEX Customer Account (if different than email used above):

example@example.com

Name of United States Academic School

Name of United States Non-Profit Academic/Government Institution

Will you be shipping your order to the address of the US Academic or Government Institution listed above?

We're sorry! Due to the terms of our NSF grant, the order must be shipped to the institution you are claiming affiliation with above.

For example if you are claiming affiliation with The University of Texas at Austin, then the shipping address should be to a location affiliated with The University of Texas at Austin. This could be a laboratory on the main campus or Pickle Research Center.

United States Academic/Government Institution Shipping Address

Street Address

Street Address Line 2

CityState

Zip Code

Reason for requesting discounted rate or an explanation of why you should qualify.

Upload your tax exempt certification or any relevant files to be considered for your discounted rate application

Choose Files

This can be a W9, 501(c)(3) certificate, or for high school students, a brief summary of your experiment.

UTEX Discounted Rates