Request for Assistance First Name Last Name Mobile Email School Email Street City State - None -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Are you part of NEO LaunchNET? - None -YesNo If Yes, which LaunchNET partner institution are you affiliated with? - None --- Select a Partner Institution --Baldwin Wallace UniversityCase Western Reserve UniversityKent State UniversityLorain County Community College Enrollment Type - None ---None--AssociateUndergraduateGraduateAlumniCommunity Venture Name Have you formed an organization yet or discussed forming one with legal counsel? --None--YesNo If so, what steps have been taken? If you have formed an entity, has an agreement (e.g., operating agreement or stockholders agreement) been signed? --None--YesNo Who are the equity holders of the organization? How much equity does each person hold? If equity has not yet been distributed, do you have any working assumptions about who will get what? --None--YesNo What is the product or service that you expect to commercialize? Do you have a sense of specific areas where you would need intellectual property protection? --None--YesNo What steps (if any) have been taken to protect any underlying intellectual property that you may have? Are there any upcoming deadlines or milestones that are driving your current development efforts? If so, what are they? Have you raised investment or obtained other funding for the organization? (This would include e.g., grant funding, prize funding/competition winnings.) - None -NoYes If so, how much? Have any of the founders or other equity holders contributed cash or anything else to the organization? If so, what and how much? We consider your income when evaluating your application. Please indicate the gross annual income of each of the founding members of the organization and name the employer(s) (if applicable). Please list all stakeholders, partners and affiliates of your project so that we can perform a check for potential conflicts of interest. Briefly describe their role and include known phone numbers, emails, and addresses. What kind of legal assistance are you requesting from the IPVC? Please be as specific as possible Submit
Request for Assistance First Name Last Name Mobile Email School Email Street City State - None -AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Are you part of NEO LaunchNET? - None -YesNo If Yes, which LaunchNET partner institution are you affiliated with? - None --- Select a Partner Institution --Baldwin Wallace UniversityCase Western Reserve UniversityKent State UniversityLorain County Community College Enrollment Type - None ---None--AssociateUndergraduateGraduateAlumniCommunity Venture Name Have you formed an organization yet or discussed forming one with legal counsel? --None--YesNo If so, what steps have been taken? If you have formed an entity, has an agreement (e.g., operating agreement or stockholders agreement) been signed? --None--YesNo Who are the equity holders of the organization? How much equity does each person hold? If equity has not yet been distributed, do you have any working assumptions about who will get what? --None--YesNo What is the product or service that you expect to commercialize? Do you have a sense of specific areas where you would need intellectual property protection? --None--YesNo What steps (if any) have been taken to protect any underlying intellectual property that you may have? Are there any upcoming deadlines or milestones that are driving your current development efforts? If so, what are they? Have you raised investment or obtained other funding for the organization? (This would include e.g., grant funding, prize funding/competition winnings.) - None -NoYes If so, how much? Have any of the founders or other equity holders contributed cash or anything else to the organization? If so, what and how much? We consider your income when evaluating your application. Please indicate the gross annual income of each of the founding members of the organization and name the employer(s) (if applicable). Please list all stakeholders, partners and affiliates of your project so that we can perform a check for potential conflicts of interest. Briefly describe their role and include known phone numbers, emails, and addresses. What kind of legal assistance are you requesting from the IPVC? Please be as specific as possible Submit
