Email completed word .docx file to: Judy.Richter@synopsys.com Synopsys University Program Preliminary Information Form Synopsys products are available under two versions: 1) University-Academic License or 2) University-External Interactions/Research License. To help us determine which category you fall under, please complete the Preliminary Application Form and email back the word .docx file. PART 1 - Site Information Complete All Fields Site Address (Sold-to Address) University Department Group within Dept. Address City State Postal Code University URL Primary Contact’s address is the “Site Address”; use this address throughout the other required paperwork. (Spell out, no abbreviations) (Spell out, no abbreviations) (Spell out, no abbreviations) (Street Address; Key/Software is delivered electronically therefore: No generic shipping & receiving nor PO Boxes) Country Department URL Primary Contact -- Instructor/Professor EST Contact -- Site/System Admin or Other Is responsible for fielding all questions from other faculty members and students, enforcing and upholding terms & conditions of license agreement. Is responsible for administration of license keys/software downloads, all end-user access, enforcing and upholding terms & conditions of license agreement. Name Email Phone Name Email Phone (university domain email address only) Fax (university domain email address only) Fax Universities cannot use SolvNet “Open A Support Case” and only the two Designated Approved Contacts (Primary Contact and EST Contact) can get technical support from the Synopsys Tech Support Center: support_center@synopsys.com. Always include university name and site # in subject header as it helps the Support Center quickly identify a valid university contact. Platform Information Both License Server and Client Server(s) should be Supported Platforms. For information on SCL version, Supported OS & Platform, Pre-Installation Information, etc: http://www.synopsys.com/Support/LI/Licensing/Pages/default.aspx. Continue on page 2, complete PART 2. If you have questions, please contact: Judy Richter WWW Sales Synopsys, Inc. Direct Phone: 503-547-6464 E-mail: Judy.Richter@synopsys.com University Program Coordinator Synopsys Technology Park, 2025 NW Cornelius Pass Road, Hillsboro, OR 97124 Synopsys University Program – Completed University Application Form is Confidential Page 1 of 2 Rev. jr010713 Email completed word .docx file to: Judy.Richter@synopsys.com Synopsys University Program Preliminary Information Form PART 2 – Status/Activities Report Complete all questions Please describe your expected use of the Licensed Product for the license period. Course(s); Select/Move curser over “” box, press “x”, box will changes to “” For more than one course, step-and-repeat the whole section, one for each course. Course Name(s) Instructor/Professor(s) Description(s) Course Level Undergraduate Graduate Masters Graduate PhD Other: Synopsys tools planned to be used Number of students attending Research Project(s); complete all questions: For more than one research project, step-and-repeat the whole section, one for each research project. Project Name Instructor/Professor(s) Project URL Description Synopsys tools planned to be used Number of professors/students participating Will the research project have other end results? If so what? Who is funding/sponsoring the research project? What kind of interactions will you have with the sponsor? Will the research project end results be made public such as through a published paper, thesis, or conference papers? Will sponsor(s) and/or any-entity-outside-of-the-university get access to your research simulation results, simulation data, or intellectual property resulting from your research? If so what? To whom? Will sponsor(s) and/or any-entity-outside-of-the-university have access to Synopsys products on-site at the university? If so what? To whom? Will any of the netlists, layout data, or HDL developed with Synopsys tools be delivered to sponsor(s) and/or any-entity-outside-of-the-university? If so what? To whom? Is the data developed in your research ever going to be transferred to sponsor(s) and/or any-entityoutside-of-the-university to be included in or used to leverage their product development efforts? If so what? To whom? Does the university have its own Fab? Will an IC be produced? What will be the feature size of the IC? Will you deliver or license the IC to the sponsor and/or any-entity-outside-of-the-university. To whom? Synopsys University Program – Completed University Application Form is Confidential Page 2 of 2 Rev. jr010713