Contact: David Andersson Chalmers School of Entrepreneurship

davian@chalmers.se +46 703805410 www.entrepreneur.chalmers.se

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PLEASE USE THIS FORM FOR SUBMITTING AN INNOVATION
IDEA FOR EVALUATION.

THIS DOCUMENT IS A WORKING DRAFT, SUBJECT TO
CHANGES AND UPDATES FROM THE SUBMITTORS SIDE.

If you already have a pre-filled submission form describing the questions in this document, it
is perfectly OK to use that to save you your valuable time.

Thank you for taking the opportunity to under secrecy - submit your idea for evaluation. In this
document we refer to an idea, but the broader meaning is an invention or innovation. This template
includes questions, which serve as the foundation for the submission of an idea for the Idea Evaluation
service in collaboration with the Idea Evaluation course given at Chalmers University of Technology and
University of Gothenburg.

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 IE (Idea Evaluation)-course. All of these parties have entered into
binding long-term 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 10
th
2014. Thank you!
By submitting your idea, you as an idea provider are obliged to serve the idea evaluation team with 3-4
hours of feedback to ensure high quality of the evaluation.

Also, feel free to contact us for any questions regarding the Idea Evaluation process.
See contact details in the end of this form.












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MERIT- AND OWNERSHIP DECLARATION OF THE SUBMITTED IDEA


Name of idea


Please insert a page summary 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 dont have to use this template if
you have your own summary use that instead. Thank you.


Inventor - Idea provider
Name:
Current address:
City:
Occupation:
Organization:
Phone:
e-mail:
Website:
Place of birth:



GENERAL QUESTIONS
Background
Give a short description of your idea (or innovation/invention) and its background.

Legal owner of the idea / invention / innovation - If company, please add corporate identity no.

Technology & functionality
Give a short technical description of your idea and its primary functionality/field of use.

At what technological stage of development is the idea currently?

Has your idea undergone any technical evaluation processes?





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Business idea
Describe the problems or needs that your idea solves.

Describe the uniqueness of your idea in relation to existing technology or comparable
alternatives.

Market
Describe your perception of the current and future target market for your idea.

Try to specify which line of business your idea is directed towards, and whether or not you
yourself have any experience in that field.

Do you see possible application of the idea in the markets in the developing world?

Financing
Describe whether or not you have applied for and/or have received any form of financing of your
idea and from whom.

SUSTAINABILITY & RESILIENCE

Sustainability

In what ways will the idea lessen the extraction of fossil resources?

In what ways will the idea lower the emission of substances from society?

In what ways will the idea lessen the need for land area or harvesting of ecosystems?

In what ways will the idea make it possible for an individual to increase its well-being?

Resilience

In what ways will the idea make it possible for society to recover quickly from large changes and
stressors.
Do you consider the idea to have positive transformational effects upon society if realized?





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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?

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
publicly known?



Thank you very much for your effort!

Please submit this document to the e-mail below before midnight December 10
th
2014. Thank you!


Best Regards,

David Andersson

Chalmers School of Entrepreneurship
Chalmers University of Technology
Vera Sandbergs All 8,
SE 412 96 Gteborg, Sweden

davian@chalmers.se
+ 46703805410
ADDITIONAL INFORMATION
In order for us to understand your innovation, comprehensive information is relevant for us. If you
have additional documentation e.g. business plans, patent applications, technical drawings or other
documentation that can describe and illustrates the idea please send them as well.

All information will be treated confidential and the individuals in the idea evaluation team have all
signed non-disclosure agreements.