CALIFORNIA INVENTION CENTER
PERSONAL PRODUCT QUESTIONNAIRE
PLEASE COMPLETE ALL THE QUESTIONS
MAKE A COPY FOR YOUR RECORDS
MAIL TO ADDRESS BELOW
PLEASE PRINT or TYPE : : :Date: ______
NAME: ______
ADDRESS: ______CITY: ______
STATE: ______ZIP: ______COUNTRY: ______
PHONE: (___) ______FAX: (___) ______email: ______
BRIEF DESCRIPTION OF INVENTION, PRODUCT, etc.
Unless patent is issued do not disclose any proprietary information
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Is a patent issued or pending & date: ______
To date I have accomplished the following results: ______
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I have contacted the following companies and the results are: ______
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Benefits over competitive products are: ______
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I want to retain the services of CIC for the following purpose(s): ______
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Please feel free to add pages to this form if you believe it to be of value
PAGE THREE
The completion and mailing of this form does not constitute any type of contractual
arrangement. It is for the sole purpose of exploring a possible collaboration or contracting with CIC for its services. We analyze the potential of the described technology/product and determine if we may be of service in either the process of
commercialization, or refer you to another organization or individual.
There is absolutely no cost involved in the filing of this document, and no fees or
charges for an initial preliminary technology/product interpretation by CIC. Since the demand upon our time is critical, and the obligations to our clients priority, we must look at any and all new opportunities to determine our potential interest and possible collaboration, both for your benefit and ours.
If you have any questions, please feel free to contact:
Lawrence J. Udell, Executive Director
California Invention Center
220 Montgomery Street, Suite 810
San Francisco, CA 94104 U.S.A
415.970.5270fax: 510.538.5200 email:
CIC was created in 1995by Professor Udell with a financial grant from three federal agencies, NIST, DOE, USPTO to provide educational materials and instructions toinventors, researchers, scientists and entrepreneurs for the economic benefits to California and America. It now serves as an international resource for both new ventures and large corporations that are seeking specific technologies and/or new products, or strategic alliances for mutual benefits.
PLEASE DO NOT SEND ANY ORIGINAL MATERIALS
Additional information supplied upon request………