Collaborative Opportunities Exploration Form

Please provide as much detail as possible for the following fields.
The more information you provide, the better we could address your needs!

. Form Submission // Enquiries . Ms. Nelly Lam . Executive Officer . 3400 2819 . .

Name of Project / Platform
Technology Area
Please check  the appropriate option(s) below:
 Life Sciences & Healthcare  Safety, please indicate area*: ______
 Aviation & Aerospace  Transportation  Sustainable Development
 Others, please specify: ______
* Area related to Safety: for example: food, mega structure, transportation, aviation, etc.
Principal Investigator
Investigators
External Collaborator(s), if any
Abstract [200 - 250 words, non-confidential]
Applications of the Technology
Features / Advantages Over Existing Technologies [in 5 Keywords or Phrases]
Stage of Project Development
Example: For drugs, please indicate whether it is in research, development, preclinical, clinical phase 1/2/3/4, or ready to market
Scientific Data, Figures and Figure Legends [2-3, Could be Separately Attached]
IP Protection Status
Please check  the appropriate option(s) below:
 Patent(s) applied, countries: ______
 Patent(s) not yet applied
 Unsure
 Other forms of IP applied, please specify: ______
Representative Publications (up to 5)
Awards
What Kind of Collaboration(s) are We Looking for?
Please check  your preferred options below, or provide other remarks in the “Others” option:
Research collaborators
 Academic / Research Institutes  Industry  Government
Development
Prototype production
 Pilot scale  Large scale
Trials
 For life sciences related trials, please indicate phase:  Pre-clinical  Clinical, Phase:____
Investment
Others, please specify: ______
Remarks / More detailed descriptions [if any]:
Publicity Preference / Confidentiality Option
The ITDO will promote university innovations from time to time at various academic and industry events. It is important for you to let us know your preference on the extent of disclosure of your research if you would like to seek potential collaborators. Please check  your preferred options below, or provide other remarks in the “Others” option:
Option 1 > I would like the ITDO to publicize this technology in promotional materials (e.g. websites, brochures, business matching platforms) for seeking collaborators.
Option 2 > I would like to seek collaborator in a confidential manner / on a need-to-know basis.
Others or remarks, please specify: ______
Note:
  1. Option 1 applies on situations when, for example:
    - you have IP protected for your technologies (e.g. patents granted, applied and published)
    - you do not intend to apply patent protection for the technology in the future
    - you already have papers published / the technology presented at a conference (i.e. it has been disclosed before and would not qualify for patent application)
  2. Option 2 applies on situations when, for example:
    - your R&D is still in early stage
    - you would like to seek patent protection in the near future
    - for any other reason(s), you would like to keep them confidential

Contact Information
Name:
Title:
Department:
Email:
Tel:

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