LAMBERT & LAMBERT, INC

Invention Licensing and Technology Transfer                                             Phone: 651-552-0080

11180 Zealand Ave North, Minneapolis, MN  55316-3594                                            FAX: 651-552-7678


 

INVENTION SUBMISSION FORM

Please sign and date the “Confidentiality Agreement” and complete the “Invention Submission Form” below.  Include payment of $199 by writing a personal check or including your credit card information in the space provided.  Mail all information to:  Lambert & Lambert, 11180 Zealand Ave North, Minneapolis, MN  55316-3594.

 

Inventor Contact Information

Name            ____________________________________          Phone  ___________________________

Address1       ____________________________________          Fax     ___________________________

Address2       ____________________________________          E-mail  ___________________________

City/State/Zip____________________________________          Country __________________________

 

Payment Method        
Check ____             Credit Card:   MasterCard ____   Visa ____   Discover ____   AMEX ____

Credit Card Number   _________________________________       Expiration ______ / ______

Name on Card           _________________________________        Signed ________________________

 

Status of Invention
Product Research and Development

 

- Are there drawings available?                                             ________Yes  ________No  

- Is there a prototype available?                                           ________Yes  ________No  

 

Current Proprietary Position

 

- Have you filed a patent application?                                    ________Yes           ________No

- Has a patent been granted?                                               ________Yes  ________No

     If so, patent number here: _______________________

 

Marketing and Licensing Efforts

 

- Have you made any efforts to market or license your

  invention, either on your own or with any other                     ________Yes  ________No

  organization or agency?  If so, please explain below.

 

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LAMBERT & LAMBERT, INC.

Invention Licensing and Technology Transfer


 

Invention Description

In the space provided below, or by attaching a document, please describe your invention.  Please include how it works, the problem that it seeks to solve, and why it is better than existing products on the market.

 

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Invention Drawing

If available, please include a drawing or rough sketch of your invention.  Either attach or draw it in the space available.