I would like to request a DNA sample of the following species:

Sample code	Species

My contact information is:

Name
Organisiation
Address
Address (continued)
Zip-code
Place
Country
Telephone no.
E-mail

I agree with the following conditions:

Requests for DNA samples will be considered from recognized botanical institutions or departments. DNA samples may only be used for research for non-commercial purposes and should not be given or sold to any third party. Secondary distribution may only be done after receipt of written approval by the Nationaal Herbarium Nederland. The recipient should acknowledge the Nationaal Herbarium Nederland in all resulting publications and send a copy to the Nationaal Herbarium Nederland. The Nationaal Herbarium Nederland reserves the right to refuse any request for DNA samples. Regulations for DNA extractions from NHN herbarium specimens can be obtained from Mr. G. Thijsse (NHN-Leiden),  Mr. R.A. Bakker (NHN-Utrecht) or Mr. F. Aleva  (NHN-Wageningen).

Outline of research project:

Additional remarks or questions: