CORBEL Innovation Helpdesk Request

CORBEL Innovation Helpdesk Request

By sending this Innovation Helpdesk Request, the CLIENT confirms that she/he has read and

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understood applicable CORBEL Innovation Helpdesk Operating Principles.

Requests can be submitted by email to the Innovation Helpdesk: .

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Section 1 – NON-CONFIDENTIAL summary

Note: NON-CONFIDENTIAL summary will be used for the review and internal control purposes only.

Project Title (max. 350 characters)

Non-confidential summary (max. 1000 characters)

Section 2 – CONFIDENTIAL

Description of project and innovation assistance requested.

All entries in this section of the form are confidential to Innovation Helpdesk experts. In the event that more information or support is required, the contents will only be shared with external experts under signed confidential disclosure agreements as required.

Submitted by

Name:

Surname:

Title:

Position:

Co-applicant(s) (if applicable)

Organisation and Address

Affiliation:

Title:

Address:

Research Infrastructure (RI) referring:

Project title (max. 350 characters)

Objectives, description and expected impact of the proposed project, collaboration or agreement(max. 700 characters)

Type(s) of innovation assistance requested

Please indicate the type(s) of assistance required (multiple categories possible):

Partnering

Advice on data sharing, access

Legal assistance with contracts

Intellectual Property advice

Help with negotiation

Open Innovation

Other, please specify:

Intellectual Property (complete only if applicable)

Have you filed a patent application (or have other forms of IP protection) for this project?

yes no

If no, then what are your plans related to Intellectual Property?(max. 200 characters)

Have you performed (preliminary) freedom-to-operate analysis on this candidate?

yes no

status:

Have you received support from your Technology Transfer Office (TTO)?

yes no

If yes, please describe the supports so far(max. 200 characters)

Are you aware of patents belonging to others that could block your own IP position?

yes no

If yes, please describe (max. 200 characters)

Please append the patent application if one exists.

Other relevant information related to Intellectual Property(max. 200 characters)

Partners/Collaborators

Do you intend to collaborate with other academic and/or commercial entities on this project?

yes no

Nature of collaboration(s)(max. 200 characters)

Name(s) of organisation(s)(max. 200 characters)

Website(s)

Envisaged model for knowledge exploitation

Describe the intended roles of the parties to exploit the findings and knowledge and their intended rights and obligations in technology transfer (max. 700 characters)

Other relevant information or references(max. 200 characters)

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