John F. Baugh Center for Entrepreneurship INNOVATION EVALUATION PROGRAM Hankamer School of Business, Baylor University Thank you for your interest in the Innovation Evaluation Program in Baylor University's John F. Baugh Center for Entrepreneurship. Enclosed is a form entitled "Innovation Registration and Disclosure." Please fill out this form as completely as possible and return it to us, along with any other information you might have about your innovation, and a check or money order for $150. Your product will be evaluated on thirty-three (33) different criteria. These criteria range from factors related to legality and safety, business risk, and demand analysis, to market acceptance and competition. The statistical analysis is relatively simple and follows three separate evaluations. 1. The Critical Value Score (CVS) is based on five criteria that must be passed in order for the product to be considered for future activities. This score must be very high— in the 80 percent plus range. 2. The Aggregate Value Score (AVS) of the 33 criteria is the overall total. It should be relatively high—60 percent plus range in order to be considered for additional activities. 3. The Estimate of Success (EOS) should be in the 60 percent plus range in order for the product to receive additional consideration. In order for a product to be considered as a serious candidate for the marketplace, it should score highly on all of the three evaluations. Thank you for your interest in our program and we look forward to hearing from you again. Sincerely, Mary Abrahams Program Administrator John F. Baugh Center for Entrepreneurship INNOVATION EVALUATION PROGRAM Hankamer School of Business, Baylor University Innovation Registration & Disclosure I understand it is the policy of the Innovation Evaluation Program at Baylor University to: 1. return all materials to me if my invention receives an Estimate of Success score of less than 60%. 2. retain my materials for 180 days if my invention receives an Estimate of Success score of 60% or greater. At the conclusion of that period, I request that you ________ return all materials to me. ________ destroy my files. If I want my materials returned after the 180 days, it is my responsibility to keep the Innovation Evaluation Program current on my address during this time. If the post office returns my materials to the Innovation Evaluation Program stamped "undeliverable," the materials will be destroyed. _______________________________ signed FOR CENTER USE ONLY File # ____ ____ ____ ____ Ind. # ____ ____ ____ ____ Submitted by: (Please print or type your name) Street address City State Zip Home Phone: Area code Phone Work Phone: Area code Phone BAYLOR UNIVERSITY CENTER FOR ENTREPRENEURSHIP INNOVATION REGISTRATION AND DISCLOSURE DISCLOSURE Please give a detailed description of your invention or innovation. Include information on the size of the device, materials, uses, and so forth. (Please describe your invention in a both technical and non-technical manner. Use the space below for non-technical description, attach technical description on separate page.) It is suggested that you have this description notarized if you have no form of protection for your invention. This establishes the date of conception of your idea. A DETAILED DESCRIPTION IS NECESSARY. State of County of On this ______ day of ____________, 19_____, before me, Notary Public, personally appeared _____________________________________ known to me (or proved to me on the oath of ____________________________________) to be the person whose name is subscribed to the within instrument, and acknowledged that he (she or they) executed the same. Witness my hand and official seal. Notary Public in and for the State of County of My commission expires INVENTION DISCLOSURE Date TO: CENTER FOR ENTREPRENEURSHIP HANKAMER SCHOOL OF BUSINESS BAYLOR UNIVERSITY WACO, TEXAS 76798 Enclosed is a description, and other materials, of my idea for registration with the CENTER FOR ENTREPRENEURSHIP (hereafter called the CENTER). After your review, I understand that you will send me your evaluation of the potential for my idea. Although the CENTER will treat my Disclosure with care, I understand that: 1. No confidential relationship, expressed or implied between me and the CENTER, its agents assigns or members, is intended either now or in the future in connection with this and all future disclosures. 2. For protection of my idea, I rely solely upon existing or future copyrights or patents which will be obtained at my sole expense. 3. Materials submitted herewith or in the future in connection with my idea may be retained by the CENTER or returned to me at my expense, at the option of the CENTER. It will be my responsibility to advise you of any change in my mailing address. 4. The CENTER acquired no right or license in my idea by this registration. If you wish to participate in the marketing of my idea, I understand that you will contact me in the future to arrange a mutually satisfactory royalty payment to you or your designee in exchange for services performed for me in the future. You have no obligation to perform any such future services, nor as I required to agree to any royalty arrangement. THE NAME OF MY IDEAS IS: I have carefully read this and the enclosed Registration form and understand their contents. ENCLOSED is my check (or money order) in the amount of $150 made payable to the CENTER FOR ENTREPRENEURSHIP, for submitting my idea named above. (signature) (Please print or type your name here) Street address City State Zip Phone: Area Witness: PLEASE fill out this form accurately and completely. This information is necessary for the evaluation of your invention. INNOVATION INFORMATION FOR CENTER USE ONLY NAME OF IDEA File # ____ ____ ____ ____ Card # ____ 1. INNOVATION DESCRIPTION: State a brief, but thorough description of your innovation in your own words so that it can be readily understood. Please attach any supporting information that you have. (If additional space is needed, please attach extra sheets) 2. INNOVATION USES AND APPLICATIONS: State any and all uses and applications for this innovation that you [7-8] have considered. 3. DEVELOPMENT STATUS: A. I currently have . . . Idea only Rough sketches and/or diagrams Enclosed Finished, working drawings Enclosed Photographs Enclosed Copies of drawings and photographs would be helpful for evaluation. B. PROTOTYPE AVAILABILITY: No prototype Functional model or prototype (If you have a model or prototype, please enclose a photograph of it.) The prototype is: Available, if requested Yes ____ No ____ C. DESIGN MODIFICATIONS: What additional changes in the design have you thought about? D. I estimate the amount of time spent on the development of this idea is The actual amount of money spent on the development of this idea is dollars. 4. LEGAL PROTECTION: I currently have . . . NO protection A PATENT Number ________ Issue Date ____________________ Copy attached a patent applied for Application date a Preliminary patent search Date of search ____________ copy of findings attached a Disclosure Document with U.S. Patent Office Date COPYRIGHT Issue date _______________________ notarized records of invention 5. PRODUCT TESTING: Testing which has already been conducted includes: none _____ functional testing (does it work as intended?) conducted by self ____ independent agency ____ user testing (consumer understands and can use conducted by self ____ independent agency ____ product with ease) marketing testing (consumer reaction) conducted by self ____ independent agency ____ product safety testing a. when used as intended conducted by self ____ independent agency ____ b. potential problems if misused conducted by self ____ independent agency ____ 6. MARKET INFORMATION: (Please be complete, as this information is extremely important) A. Current competition--Please list existing products or processes that do a similar job. B. Competitive advantages--Why is your innovation better than existing products or processes? Please list the most important advantages in order of importance; i.e., Number 1 equals most important. C. Projected Market--Who will use your invention? Please list users in order of importance; i.e., Number 1 equals most important. 1. Major users: 2. Possible other users: D. Previous Marketing effort--If a previous attempt has been made to sell your product, please supply the following information (please include complete results): Date(s) of marketing effort Location of marketing effort Number sold ________ Selling price __________ Manufactured by Reason for discontinuing marketing effort. Please list most important reasons in order of importance; i.e., Number 1 equals most important. E. Previous agreements--I have entered into prior agreements relative to this invention with: Individual(s) Purpose Date Still in effect 7. PRODUCT COST (Please include accurate source information, including telephone number and addresses.) Materials (per unit) Date of estimate Source Labor (per unit) Date of estimate Source Manufacturing equipment (dies, molds, etc.) Date of estimate Source (If additional space is needed, please use separate sheet.) have made no attempt to gather this information. 8. CUSTOMER ACCEPTANCE: I have planned for or developed . . . product visual appearance for customer appeal ___ proper user instructions packaging design for protection ___ display ___ shipping ___ customer appeal none of the above with professional assistance ___ on my own. (Please supply details.) 9. FURTHER DEVELOPMENT NEEDED: Please indicate in what order the items in each section are important to you; i.e., Number 1 equals most important. Number 2 equals second most important. A. RESEARCH AND DEVELOPMENT ___ determining technical feasibility ___ researching manufacturability ___ obtaining cost information ___ analyzing customer acceptance and use patterns ___ prototype development B. NEW OR ON-GOING VENTURE ___ locating a manufacturer ___ locating a distributor ___ locating a new or expanded market ___ preparing a marketing plan ___ preparing a business plan ___ locating a source of venture capital C. LICENSING OR SALE OF INVENTION ___ locating a buyer for outright sale of invention ___ licensing manufacturing and marketing for a royalty 10. PLEASE STATE YOUR SPECIFIC NEEDS IF NOT COVERED BY QUESTION 9. 11. PERSONAL INFORMATION (This information is useful in understanding and assisting independent inventors; it is for statistical use only, and is kept confidential.) A. Current occupation (or occupation before retirement) Are you currently . . . Name of employer ___ employed? Employer's address your job title ___ self-employed? Name of your business your business address ___ Engaged in small business? ___ Engaged in large business? ___ Retired? ___ Unemployed ___ Student? Where? Major? ___ Faculty? Where? Department? B. Birthdate ______________________ Male___ Female ___ 12. From what source did you first learn about the Center for Entrepreneurship at Baylor University? (Please be as accurate as possible, as this helps us in determining ways to reach independent inventors.) 8