Technology Refinement and Marketing Plan (TREMAP) Program

www.venturecenter.co.in [email protected] Phone: 020-64011026 100, NCL Innovation Park, Dr. Homi Bhabha Road, Pune-411008, India. (Entrepreneurship Development Center)

Technology Refinement and Marketing Plan (TREMAP) Program http://www.venturecenter.co.in/tremap/ The TREMAP program helps individual technology innovators to commercialize their technology via industry partners/ entrepreneurs by helping them demonstrate a business case, develop a refinement and marketing plan for the technology and help identify potential licensors.

Ref. no. – Date - Application Form

1. Applicant information

1.1 Applicant full name

1.2 Nature of entity Individual/ Micro or Small or Medium scale Enterprises

Other (Please specify):

1.3 Affiliation/ profession

1.4 Full postal address for correspondence

1.5 Phone

1.6 Fax

1.7 Email

1.8 Nationality www.venturecenter.co.in [email protected] Phone: 020-64011026 100, NCL Innovation Park, Dr. Homi Bhabha Road, Pune-411008, India. (Entrepreneurship Development Center)

2. Brief non-confidential description of the technology/ invention

Title of Technology/ Invention

PROBLEM/ NEED: What is the problem solved or outstanding need meet by the invention?

SOLUTION: What is the solution provided by your invention?

DISTINCTION: How is your solution different from other available solutions to the same problem? Compare with competing products/ services? What is the key added advantage?

Current status of technology Select Status An idea An idea with detailed conceptual plan, drawings, designs etc Proof of concept/ principle completed Patents filed At least one prototype demonstrating value to target customer developed Preliminary discussions with potential licensors/ investors carried out Has your technology/ invention been recognized or honoured or given any awards by independent agencies/ organizations? www.venturecenter.co.in [email protected] Phone: 020-64011026 100, NCL Innovation Park, Dr. Homi Bhabha Road, Pune-411008, India. (Entrepreneurship Development Center)

3. First level self- assessment for fit info TREMAP scheme

3.1 Clear/ undisputed rights of technology/ invention is owned by Yes/ No individual innovator 3.2 Inventor/technology developer is seeking to license/ assign Yes/ No technology/IP rights to a unrelated party 3.3 Inventor/technology developer needs help in marketing and Yes/ No licensing technology 3.4 Technology has reached prototype stage and needs only some Yes/ No refinement/ testing etc 3.5 The technology has at least one novel component/ appears Yes/ No innovative 3.6 The technology appears patentable Yes/ No  Technology is not in the exclusion list  Technology has novel elements  Invention is non-obvious with respect to known technologies/ inventions/ literature  Invention has clear uses/ applications 3.7 The technology is scalable Yes/ No  The scale of technology implementation can be increased as per need. A clear path can be projected for scaling up technology (with potentially some scale-up risk)  The technology could potentially serve a reasonably large market 3.8 The technology is not in the exclusion list of TREMAP: Yes/ No  Commercialization of “pure” software (Embedded ICT systems with software can, however, be supported).  Defense technologies like arms & armaments  Herbal & pharmaceuticals products requiring long duration/ extensive testing, trials etc. www.venturecenter.co.in [email protected] Phone: 020-64011026 100, NCL Innovation Park, Dr. Homi Bhabha Road, Pune-411008, India. (Entrepreneurship Development Center)

4. Patent details (Applicable if patent has already been filed)

4.1 Patent applications: Provide Attach as Appendix 1 list here with  Title  Inventors  Country/region  Application number  Filing date  Current status 4.2 Attach first page of Attach as Appendix 2 published patent 4.3 Nature of invention Select Type of invention/ potential claims Composition of matter Material with certain features Product/device Method of use Process or method Algorithm per se Any others

5. Declaration:

I have studied the scheme information provided at http://www.venturecenter.co.in/tremap/ and understood the TREMAP process flow and scope of scheme benefits.

I understand that at this stage I am applying for the TREMAP program with no commitments or obligations from both parties.

I declare that all the statements made in this application are true, complete and correct to the best of my knowledge and belief.

Place: Signature of the applicant