TechConnect World

Innovation Submission

We recommend using this Microsoft Word document as a tool to assist in saving and completing your submission.
Fields marked in bold must be completed.


Contact Information

First name:
Last name:
Organization:
Job title:
Address:
City:
State:
ZIP:
Country:
Phone:
Cell phone:
Fax:
E-mail:
Confirm e-mail:
 Note: Your contact and innovation/company information will be made available to corporate/investment partners and conference attendees if your organization is invited to participate in the summit.

Organization Information

Company or Organization:
Website URL:
Organization size:

Innovation/Company Details

Title/Name of Technology:
Technology Summary:
50 word(s) left.
Executive Summary:
200 word(s) left.
Technology Development Status:
SelectTechnology Readiness Number (TRL):
 TRL numbers are defined here: esto.nasa.gov/files/TRL_definitions.pdf
Organization Type:
Primary Application Area:
Other:
 (if you selected Other in the pull-down above)
Specific Market Keywords:
 Enter up to 3 market descriptors separated by commas.  Please help us find your best fit corporate or investment partner by narrowing down your specific market focus. Please take care in this essential selection and partnership step.
Technology Keywords:
 Enter up to 3 technology keywords separated by commas.  Again, this step is essential in our partnering process. We request that you provide a very concise set of key words summarizing “what technology approach” do you use in addressing your key market.
Government Program Funding/Support to-date:

Please select the Government Program(s) that support your Innovation/Company (select all that apply):

DOD SBIR/STTR
DOE SBIR/STTR
NIH  SBIR/STTR
SBIR/STTR Other
State Grant/Loan
Federal (non-SBIR/STTR) Grant/Loan
N/A (no funding/support received)

500 word(s) left.
 Please provide any additional details on Government programs checked above (Phase I-II-III, Agency/Sub-Agency/Component/Office, Award Amount, Year/Duration)
Non-government Funding/Support:
50 word(s) left.
 List any disclosable financing to-date, i.e., Angel, Venture, Corporate, etc.
Awards and Vetted Programs:
200 word(s) left.
 List any involvement in vetted programs or awards, i.e., TechConnect National Innovation Award, R&D 100 Award, Rice Alliance Venture Finalist, CTSI Defense Energy Challenge, etc.
License or Partner Agreements:
200 word(s) left.
 List any disclosable licensing or corporate/government partnerships tied to your Innovation/Company
Market Size & Strategy:
200 word(s) left.
 Define what your addressable market, market size and your market strategy?
Management or Innovation Team:
300 word(s) left.
 Please document 3 key business or innovation team members?
Who/What is your Competition?:
50 word(s) left.
What is your value proposition?:
50 word(s) left.
 What makes this IP attractive to the market? How is this an improvement over an existing technology or company? Answer the question “So What?”
Are you looking for:
What are your primary sources of funding?
Angel, Friends, Family
Venture Capital
Corporate Venture Capital
Corporate Partner
Personal Savings
Federal Grant
University
Other
  
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