PLEASE USE THIS FORM FOR SUBMITTING AN INNOVATION IDEA FOR IDEA EVALUATION If you already have a pre-filled submission form describing the questions below, it is perfectly OK to use that as well to save you your valuable time! This template includes questions which serve as the foundation for the submission of an idea for the Idea Evaluation service. We would like you to answer these questions as thoroughly as possible, and if you need help or further explanations in this process, we will be happy to help. All answers will be held confidential, as will any other information pertaining to the idea. The answers will only be provided to the management team, analysts and selected students at the IEFS (Idea Evaluation and Feasibility Studies)-course. All of these parties have entered into non-disclosure agreements that can be received upon request. Furthermore, this report is administratively labelled as a non-published working material, making it not applicable to the Swedish principle of publishing data stemming from the university. Please submit your innovative idea before midnight december 21st 2011. Thank you! Also, feel free to contact us for any questions regarding the Idea Evaluation and Feasibility Study process. See contact details in the end of this form. MERIT- AND OWNERSHIP DECLARATION OF THE SUBMITTED IDEA Name of idea Description of the idea or innovation. NOTE: The above info, including the contact details below, is enough for starting the analysis, however, feel free to fill in complementary info on the following pages. You don’t have to use this template – if you have your own summary use that instead. Thank you. 1 Name of idea owner (Please include a list of the qualifications requested below for each idea provider and/or group member) Profession/Speciality Address Zip code, location Telephone, home Telephone, Mobile Telephone, work E-mail Education and Experience 2 ADDITIONAL QUESTIONS Background Give a short description of your idea (or innovation/invention) and its background. Technology & functionality Give a short technical description of your idea (innovation/invention) and its primary functionality/field of use. At what technological stage of development is the idea currently? Describe briefly which stages still need to be completed, and an approximate time estimate for these. To what extent has the idea and its usage been validated? Has your idea (innovation/invention) undergone any technical evaluation processes? List and briefly describe these processes. Do you consider the idea to have positive transformational effects upon society if realized? Business idea Describe the ”problems” or needs that your idea (innovation/invention) solves, and by what means your idea solves these problems. Describe the uniqueness of your idea (innovation/invention) in relation to existing technology or comparable alternatives. Describe what use a potential customer will have of your idea (innovation/invention) within one or several relevant application areas. Market Describe your perception of the current and future target market for your idea (innovation/invention) and whether this market is mainly local, national or international. Try to specify which line of business your idea (innovation/invention) is directed towards, and whether or not you yourself have any experience in that field. Financing Describe whether or not you have applied for and/or have received any form of financing of your idea (innovation/invention) and from whom. Environmental Sustainability In what ways will the idea (innovation/invention) provide for a more effective way of using the Earth’s resources? Has a life cycle assessment been made in regards of the impact of a future application of the idea (innovation/invention)? Does the idea (innovation/invention) provide a possibility to enable a fossil-free industry? Has the innovation/invention a possibility to have components that can be recycled/”upcycled” in a “cradle-to-cradle” manner or is it reliant on components of limited supply? Does the applicationof the invention increase biodiversity on a larger scale? 3 LEGAL QUESTIONS Possibility of protection If you yourself have developed the idea, have you done this on your own or together with others? Have any agreements, oral, written, or otherwise, been established with the other contributors to the idea? What aspects of the idea are regulated in these agreements (e.g. ownership, future profits, or the right to publish)? If there are no agreements with other idea providers, on what basis do you feel that you have the right to claim ownership of the idea? Spreading of Information & value of novelty Is the idea in any way protected by any intellectual property rights, including but not limited to patent(s), patent application(s), copyright(s) or trade secrecy. If the idea does not have intellectual property protection today, to what extent is the idea (innovation/invention) publicly known? Thank you very much for the effort! Please submit your innovative idea before midnight december 21st 2011. Thank you! Best Regards, David Andersson Innovation Advisor – Transformative and Sustainable Technologies Chalmers University of Technology & University of Gothenburg Division MORE – Management of Organizational Renewal and Entrepreneurship Vera Sandbergs Allé 8, SE 412 96 Göteborg, Sweden david.andersson@entrepreneur.chalmers.se + 46 31 786 00 00 4