Please Email the Completed Inventor Data Sheet to

Please Email the Completed Inventor Data Sheet to

<p> INVENTOR DATA SHEET</p><p>Please email the completed Inventor Data Sheet to [email protected]. Title of Invention: </p><p>Contribution: Briefly describe your contribution to the disclosed technology.</p><p>Inventor: First: MI: Last: Ms. Mrs. Mr. </p><p>PhD DVM MD MS/MA BS/BA Other: Please name any joint appointments and/or affiliation that you have with another institution, including but not limited to joint appointments within TAMUS (if any):</p><p>University ID Number (UIN): Country of Citizenship: </p><p>Work Address: Home Address: street address street address city/state/zip city/state/zip phone phone fax fax work email home email</p><p>TAMUS Employment Status/Title (including former employees):</p><p>Professor Associate Professor Assistant Professor Employed Student</p><p>Other Status/Title (if not listed above): </p><p>Former Texas A&M University System Employee If you checked “Former Texas A&M University System Employee,” were you employed by the A&M System at the time of technology or discovery? YES NO</p><p>TAMUS Member (AgriLife, TAMU, TEES, TTI, TAMU-Kingsville, TAMU-Corpus Christi, etc.): Department/Division: Laboratory or Center: Non-TAMUS Employment Status/Title (for non-TAMUS inventors only): Please provide your Position/Title and Company Name: </p><p>Form Revised 09/07/2016 Form Revised 09/07/2016</p>

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