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Cardozo Patent Diversity Project Clinic - Inventor Application Form
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Name
*
First and last name
Your answer
Email
*
Your answer
Phone number
*
Your answer
Address
*
Your answer
Gender Identity
*
Your answer
Do you identify with a minority group? If so, which one?
*
Your answer
Are you a U.S. Citizen or a legal U.S. resident?
*
Yes
No
Required
Number of people in your household including you
*
Your answer
What is your annual gross income? If you are identified as a dependent on another’s tax return or others are identified as dependents on your tax return, please provide the annual household income.
*
Your answer
Please provide a general description of your invention.
*
Your answer
Do you have any documents or notes describing your invention?
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Yes
No
Required
Did anyone else work with you on the invention or provide you with financial assistance relating to your work on the invention?
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Yes
No
Not sure
Required
Did you do this work as part of your employment?
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Yes
No
Not sure
Required
Have you discussed or shown your invention to anyone else?
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Yes
No
Not sure
Required
Have you spoken with any attorneys regarding your invention?
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Yes
No
Not sure
Required
If yes, please describe
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What is your prior knowledge regarding patents?
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Have you ever filed a patent application on a different invention?
Yes
No
If yes, please provide the application number(s)
Your answer
How did you learn about the Patent Diversity Project Clinic?
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Your answer
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