PRODUCT/TECHNOLOGY/SERVICE INNOVATION

THE CONSULTATION FEE OF $175 INC. GST IS PAYABLE ON THE DAY.

We accept cash / cheque and credit cards.

 

Notice of postponement or cancellation must be received 24 hours prior to your appointment to avoid a cancellation fee.

 

INNOVIC agrees not to disclose the confidential information you provide to us without your prior approval, however if you require a separate Confidentiality Agreement, complete our Confidentiality Agreement Form here and bring it along with you to your consultation.

 

The consultation will be held at INNOVIC’s office Level 10, 492 St Kilda Road, Melbourne.

Please complete the following where relevant and as best you can.

Name (required):

Date:

Company Name (required):

Address:

Contact number (required):

Website:

Email (required):

Would you like to receive INNOVIC's free monthly e-newsletter?
(It lists grants, seminars, events and items of interest to innovators).
YesNo

Innovation Details

Innovation Type (required):
ProductTechnologyServiceOther

Name of innovation (if applicable):

Brief Description: e.g. underground water storage tank with easy installation (required)

Intellectual Property

Have you applied for IP protection?
YesNo

If Yes, what have you applied for?
Provisional PatentInnovation PatentRegistered DesignTrade MarkOther

Business Registrations

Have you registered:
Domain nameBusinessCompanySole Trader/ABNPartnershipOther

Market Research

Complete where applicable

Who will buy your product or service?

Who are your competitors?

Have you undertaken any market research?
YesNo

If yes, please detail:

Do you have any relevant experience or expertise in the field of your innovation?
YesNo

Development Stage

What stage of development are you at? (required)
Early stage (e.g. just an idea)Prototyping/testingDevelopment (manufacturing)Later stage/ready to commercialiseOn the market

Commercialisation Options

What would you like to do? (required)
License or sell the innovation to a third partyArrange a strategic partnership or joint ventureEstablish a businessOther

If other, please explain:

Finances

Do you have the funds to support the development of your idea/business?
YesNo

Assistance

What kind of assistance do you require? (required)
Evaluation and feedbackIntellectual property adviseProduct / technology / web / app design / prototyping / developmentBrand / logo / packagingCommercialisation services (path to market, rollout and strategy)Marketing and business plansGrants and fundingIdentifying licensees / join venture partners / manufacturers / distributors / agentsOther

If other, please explain:

Other information

How did you hear about INNOVIC?
OnlineTVRadioPrintFriendH&R BlockOther

I am a H&R Block client:

YesNo

Confidentiality Agreement

If you want us to sign a Confidentiality Agreement please complete this form, print it and bring it to the consultation for signing.


PRINT BEFORE SENDING

Print Form