First Name

Last Name

Email Address

Phone Number

Name of your invention

Please provide some details of your invention, including a description of how it works.

Do you have a patent on your idea? Do you have a patent on your idea? Yes No

If yes, please provide associated patent links and applicable information.

Do you have a working prototype? Do you have a working prototype? Yes No

What's a problem on the market or in society that your product solves?

What would you say is a standout feature of your product? How is it different from alternatives on the market now?