WIN-I2

 

WORLD INNOVATION NETWORK-INNOVATION INSTITUTE

 

 

INVENTION EVALUATION SERVICE

OFFICE USE

 

PROJ. NO.__________

 

REC

 

FIN

 

CAR  ______________
 
(www.wini2.com)

 

 

 

 

PIES-XII

Preliminary Innovation Evaluation System

(Twelfth Edition)

 

 

CONFIDENTIAL

NEW PRODUCT, IDEA & INVENTION

 REGISTRATION AND DISCLOSURE DOCUMENT

Short Form*

 

 

 

Submitted by:

                                                                        Please Print or Type Your Name

 

 


                                                                                     Street Address

                                            

 


                                                            City                              State                                        Zip

 

Home Phone (         )                 -                                               Work Phone (          )               -

 

 


E-Mail Address             

 

 

Name of Invention

 


*This form is designed for use by those who have an idea for a new product, or are at the early stages of developing an invention, and have little information about their idea or invention, but want to obtain a preliminary commercial evaluation of their idea or invention for decision making purposes before they invest a lot of money in obtaining patent protection or a prototype of their idea or invention. Those with more advanced projects may want to use the larger standard WIN-I2 form to provide more details.

 

 

 

 

                                                                    INNOVATION INSTITUTE                                                                    

 852 Highway MM                                                                     

Everton, MO 65646                                                                   

 

 

 

Copyright 2007 by the Innovation Institute.

 

 

 

INVENTION EVALUATION SERVICE

WIN-I2 INNOVATION CENTER

 

CONFIDENTIAL DISCLOSURE AGREEMENT

 

 

Enclosed is a description of my idea and other materials for registration with the WIN-I2 Innovation Evaluation Program (ISP)  for the purpose of a PIES-XII commercial feasibility analysis.   I understand that:

 

1.       The information that I am sending you, including my name and address, is A. a trade secret, or B. commercial or financial information that is privileged or confidential, and as such qualifies for exception from the Freedom of Information Act under 5USC552(b)(4) in the United States.

 

2.       WIN-I2 and its agents hereby agrees, covenants and contracts not to use, sell, or disclose in any manner, or utilize for profitable gain, the suggestion, invention and/or idea hereby disclosed by the below-named inventor unless prior written permission is obtained from the person(s) signing this disclosure.  In addition, WIN-I2 will not disclose any specific information about my idea or invention to other inventors with similar ideas or inventions; although it may acknowledge that relevant prior art does exist.  While I desire to know about the existence of similar prior art, I understand that WIN-I2 will not disclose to me any specific information about similar ideas and inventions that it has reviewed previously.  WIN-I2 recognizes that it acquires no rights whatsoever by virtue of its evaluation of my idea or invention.

 

3.       This information is submitted for the sole purpose of obtaining a commercial feasibility evaluation of my idea/invention.  I understand this evaluation will be based not only on the functional and design merits of my idea or invention, but in rendering a professional opinion of my idea/invention WIN-I2 will also consider such factors as barriers to market entry, past and present alternative products, prior art, nature of competitive forces, market demand and market structure and that it will attempt to assess the risks and the rewards associated with my idea/invention.

 

4.       Materials and samples submitted herewith, or in the future, in connection with my idea/invention/new product may be retained or destroyed by WIN-I2 at their discretion.  I have not supplied any original documents or one-of-a-kind prototypes, and I give permission to WIN-I2/ISP to retain or destroy any or all of the materials/samples supplied by me at any time of its choosing.

 

5.       WIN-I2 is an evaluation service and in an effort to avoid even the appearance of a conflict of interest, does not provide other fee-based services to its clients.  Any additional services provided by WIN are provided at no cost to the client and at WIN-I2’s option only.

 

 7.   Only a very small percentage of inventions and new product ideas eventually become successful products.  All   evaluation formats should reflect this reality.  Under the PIES format a sample of PIES- XI evaluation scores in 2004-2006 revealed that 26.1% received a ”Red Light” not recommended), 60.4% received a “Yellow Light” (33.4% -very limited and cautious & 27.0% limited and cautious) ratings.  At the other end of the spectrum, 9.6% obtained a “Flashing Green Light” (a rating of 40-41 CAR, and 3.9% achieved a “Green Light” (a rating of 42-45 on a 100 point Commercial Assessment Scale.  I understand that commercial evaluations or assessments, are helpful in reducing the risk of investing in unprofitable ventures.  Accordingly, I desire a PIES-XII Evaluation.

 

6.       I UNDERSTAND THE FEE FOR A PRELIMINARY INNOVATION EVALUATION IS $200 in the United States and $220 elsewhere (the additional $20 is to cover added postage costs).  All checks drawn on non-US banks must be in U.S. dollars.  Please enclose your check made payable to the Innovation Institute.

 

 

YOUR CHECK MUST ACCOMPANY YOUR EVALUATION REQUEST.

Please make checks payable to the Innovation Institute (I2).   Thank You.

 

The Name of my idea is:

 

I have carefully read this, and the enclosed Registration form, and understand their contents.

 

 


                                                     (signature)                                                                             (please print or type your name here)

 

Copyright 2007  Innovation Institute

 

 

 

 

WIN-I2

 

CONFIDENTIAL IDEA/INVENTION INFORMATION

 

 

PLEASE provide this information the best that you can.  If a question, or part of question, does not apply to you, skip to the next question.  This information will be helpful in evaluating your invention.  For your protection, DO NOT SEND ORIGINAL DOCUMENTS OR ONE-OF-A-KIND PROTOTYPES.  You may send non-returnable samples or videotapes if you wish.  In the interest of keeping the cost of our services as low as possible, these materials/samples will not be returned, and will be retained/destroyed at the discretion of WIN-I2/ISP.

 

 

1.                   DEVELOPMENT STATUS: I currently have....

           Idea only                                                              finished, working drawings       

           Prototypes                                            Rough sketches / diagrams        

Copies of drawings and photographs would be very helpful for evaluation -- no originals -- only copies please.

 

2.         COMMERCIALIZATION PLANS:

A.                  How do you plan to get your new product, idea or invention into the marketplace?  Please rank 1, 2….

           Start new venture                      Sell or license your invention to someone else.

           Manufacture/market yourself through an existing business you already own/are involved in.

B.                  Are you working, or have you worked with, any organizations to assist you in the commercialization

of your product idea?                 Yes             No

If yes, who                                                                                                                                            

 

3.         LEGAL PROTECTION:  Do you have any legal protection for this idea/invention?                 Yes             No  

IF YES, Please provide details.

__Provisional App. __Patent Applied For: __Design __Utility ___Patent Issued: ___Design ___Utility      Date___

 

4.         COST/PRICE:  How much you think your new product will:

Cost to manufacture __________             Don’t know__________

Sell for at retail__________                     Commercial/industrial end user price __________

 

5.         COMMERCIALIZATION:

            A.  How do you plan to get your idea/invention into the marketplace?

                        ___Start a new venture                           ___Sell/license your idea/invention

___Manufacture through a business you already own/are involved in.

B.   Are you working, or have you worked, with any organizations to assist you in the commercialization of your      idea/invention?  ___Yes,  ___No.  If yes, who? ____________________________________________________

 

6.             CONFIDENTIAL NEW PRODUCT IDEA & INVENTION DISCLOSURE

Please provide a brief non-technical description of your idea or invention on the next page.  You may use additional pages as necessary, or to send a technical description.  We are most interested in the purpose of your idea or invention and the function it provides.  You may provide more detailed information including drawings, photographs or other materials, but this is optional and not required for evaluation purposes.  Do not send any original documents or prototypes.  WIN will destroy or retain all materials at its discretion.

 

 

 

PLEASE START DESCRIPTION HERE AND ADD PAGES AS NECESSARY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  

PLEASE SEND COMPLETED FORM TO:

          WIN/INNOVATION INSTITUTE                      

        852 HIGHWAY MM                                               

                                                                             EVERTON, MO 65646                             

  SPRINGFIELD, MO 65897