Personal Data of the applicant Surname Address Building & Street (office address representing the ZIP entity, shall receive the funding First Name City (e.g. the institute,) Country Name of Institute / Add address if Building & Street Entity / Company / different from Start-up the above ZIP proponent is affiliated to City Country Name and Place of Add address if Building & Street research different from (where the research described - ZIP below will be performed) City Country Technology Proposal Description of the game-changing technology (limit: 1000 characters) Possible application fields (limit: 500 characters) Are you working on the technology? Yes No If not: who is leading in the field? Is this technology patent protected? Yes No Don’t know If yes: could you name primary patents? Do publications exist for this technology? Yes No
Personal Data of the applicant Surname Address (office address representing the entity, shall receive the funding (e.g. the institute,) Building & Street ZIP First Name City Country Name of Institute / Entity / Company / Start-up the proponent is affiliated to Add address if different from above Building & Street ZIP City Country Name and Place of research (where the research described below will be performed) Add address if different from - Building & Street ZIP City Country Technology Proposal Description of the game-changing technology (limit: 1000 characters) Possible application fields (limit: 500 characters) Are you working on the technology? Yes No If not: who is leading in the field? Is this technology patent protected? Yes No Don’t know If yes: could you name primary patents? Do publications exist for this technology? Yes No
application-registration-350-next-game-changing-technology-en.docx