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*I am submitting this form on behalf of... *I am submitting this form on behalf of...Individual PersonOrganization: For ProfitOrganization: Non-profitPOCPGMSC

*First Name

*Last Name

Title

Organization Name (if applicable)

*Email

*Primary Phone (Include country code and area code)

Secondary Phone (Include country code and area code)

Fax

*Mailing address (Please include your street, city, state/province, zip/postal code, country/region)

*I have an idea for a... *I have an idea for a...ProductService

*Development Status *Development StatusIdea OnlyWork in ProgressFinished Work

*Availability of Prototype *Availability of PrototypeNo PrototypeFunctional Model or PrototypeMarket Ready Prototype

*Existing Legal Protection *Existing Legal ProtectionNo ProtectionPatent PendingPatentCopyrightNotarized Record of Invention

*Suggested Product Name

*Description of the Product

*Product Components

Documents Available Documents Available PowerPoint Presentation Supplementary Pages for Handouts Summary of any Video Included Proposed Duration of Service Timeline for Delivery Goals/Objectives of Service Summary of Materials and/or Equipment Required No Documents Available

Existing Legal Protection Existing Legal ProtectionNo ProtectionCopyrightTrademarkServicemark

*Suggested Service Name

*Description of the Service

*Language Adaptability

*Cultural Adaptability

*Target Consumer

*Estimated Market Size

*Expected Market Growth

*Cost to Manufacture Product

*Manufacture's Name

*Estimated Unit Selling Price

*Estimated Unit Profit Margin

*Estimated Sales per Annum

*Estimated Product Life

*Potential Distribution Methods *Potential Distribution Methods Hardcopy Downloadable Other

Technological and Audio-Visual Requirements

*Estimated Selling Price

*Estimated Cost of Service

*Estimated Life of Service (before revision is required)

*Potential Methods of Service Provision *Potential Methods of Service Provision Live Online Webcast Other

Additional Comments

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