AUC Innovation Disclosure Form

Confidential Innovation Disclosure Form

General Information - Page 1/4
Enter a brief title that describes your innovation *
Share any abstracts that you may have already developed that describes the innovation *

0/2000
Primary contributor's full name *

First Name Middle Name Last Name
Primary contributor's email address *
Primary contributor's Department at AUC *
Primary contributor's Citizenship *
Primary contributor's home address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Primary contributor's primary mobile phone number *
Please add contributors to the form as necessary (dynamic table) (Scroll right to ensure you fill in the mandatory mobile number field)
2nd AUC Department that was involved (if any)
3rd AUC Department that was involved (if any)
Briefly describe the role and contribution of each contributor to the development of this innovation *

0/1500
Do you have any documents that describe your innovation and would like to share? Please upload these here

Upload One or Multiple Files

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Please share any image(s) that you produced relating to your invention that can be used for future marketing purposes

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Confidential Innovation Disclosure Form

Technical Details about the innovation - Page 2/4
Briefly describe your innovation *

0/2500
Describe the key aspects of the innovation *

0/2000

Confidential Innovation Disclosure Form

Market relevant details about the invention - Page 3/4
What is the problem that your innovation solves? *

0/2500
What are the key advantages that your innovation introduces? *

0/2000
When was the innovation first conceived and when and where was it reduced to practice?

0/800
What practical work has been done so far? *

0/1000
Where do you believe your innovation lies on the technology readiness scale below?
Do you have plans to further develop this particular innovation towards a market-ready product or service? If yes, please share how you plan to do so. *

0/1000

Confidential Innovation Disclosure Form

Funding and prior art details - Page 4/4
Are you aware of other literature that describes similar (or competing) technologies?

0/4000
What applications and uses do you envision for the innovation? *

0/1500
Are you aware of any entities who would be interested in your innovation? If so, please share a list of these with contact details, if available

0/800
How was your Innovation funded? *

0/600
Please share all keywords you feel would be best used when conducting an online search to identify closely competing innovations *

0/400
If you disclosed or published anything relevant to the invention, please mention to who, where and what? *

0/600
Do you have plans to publish? *

0/400
Are you Human? *
Please contact the Technology Transfer Office (tto@aucegypt.edu) if you have any questions. By clicking Submit below, all the listed contributors certify that all information provided herein is true and accurate to the best of your knowledge.
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Confidential Innovation Disclosure Form