RPC NO. __________ ACCT. NAME ____________ RPC Use Only INVENTION DISCLOSURE FORM UW Inventors* – *Note: For Use by University of Wyoming Inventors For additional instructions, see page 5 1. TITLE OF INVENTION In describing the technology, please provide when possible 2. DESCRIPTION OF INVENTION: information covering the following points: the general purpose; a technical description (images, figures, in-depth descriptions should be appended); the advantages and improvements over the existing methods, devices or materials Please Use Text Box for Describing Technology and/or Attach Additional Pages 3. INVENTOR(S) (If more than 3 inventors, please download Additional Inventors Form) Name: Title: Dept: Work Phone: Work Fax: Home Phone: Home Address: City: State: Zip: Name: Title: Dept: Work Phone: Work Fax: Home Phone: Home Address: City: State: Zip: Name: Title: Dept: Work Phone: Work Fax: Home Phone: Email: Home Address: City: Zip: 4. CONTRIBUTION Inventor Name: Contribution (%): Inventor Name: Contribution (%): Inventor Name: Contribution (%):
RPC NO. __________ RPC Use Only ACCT. NAME ____________ INVENTION DISCLOSURE FORM – UW Inventors* *Note: For Use by University of Wyoming Inventors For additional instructions, see page 5 1. TITLE OF INVENTION 2. DESCRIPTION OF INVENTION: In describing the technology, please provide when possible information covering the following points: the general purpose; a technical description (images, figures, in-depth descriptions should be appended); the advantages and improvements over the existing methods, devices or materials Please Use Text Box for Describing Technology and/or Attach Additional Pages Name: Title: Dept: Work Phone: Work Fax: Home Phone: Home Address: City: State: Zip: 3. INVENTOR(S) (If more than 3 inventors, please download Additional Inventors Form) Name: Title: Dept: Work Phone: Work Fax: Home Phone: Home Address: City: State: Zip: Name: Title: Dept: Work Phone: Work Fax: Email: Home Phone: Home Address: City: Zip: 4. CONTRIBUTION Inventor Name: Contribution (%): Inventor Name: Contribution (%): Inventor Name: Contribution (%):