INVENTOR QUESTIONNAIRE YOU MUST HAVE A CURRENT PROVISIONAL OR PATENT APPLICATION FILED TO PARTICIPATE I HAVE AN IDEA ONLY CLICK HERE "*" indicates required fields Name* First Last Age*Please enter a number from 0 to 99.Email* Phone*Are you active or retired Military?* Yes No Which branch?ArmyNavyAir ForceMarinesCoast GuardNational GuardPlease upload a photo of the front & back side of your ID card:* Drop files here or Select files Max. file size: 50 MB. Are you active or retired First Responder?* Yes No Which department?FirePoliceEMSPlease upload a photo of the front & back side of your ID card:* Drop files here or Select files Max. file size: 50 MB. What is your location?* City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Is this your first invention?* Yes No What industry does your product fall under?*Apparel/AccessoriesFitness / SportsFood / BeverageHealth / WellnessHousewaresLawn / GardenPersonal CarePetsSeasonalTacticalTech/ElectronicsTools / HardwareToys/GamesVideo/PhotographyOtherIndustry:* Who is your target customer?* What is the Age Range for your customer?From Age:*Please enter a number from 1 to 99.To Age:*Please enter a number from 1 to 99.What type of business is this?* B-to-C (Business to Consumer) B-to-B (Business to Business) B-to-G (Business to Government) Social Impact or Non-Profit Subscription Business Select AllWhat problem(s) does the product solve?* How big is the problem?* How do you know this is a big problem?* What market research have you done?* Have you conducted a Worldwide prior art search?* Yes No Who did the search?* I did it myself Patent Attorney Patent Agent Other Have you filed any provisional patent applications?* Yes No What type?* Utility Design Plant Other When does it expire?* MM slash DD slash YYYY Do you know the difference between a Design Patent and a Utility Patent?* Yes No Have you created any CAD files for this idea?* Yes No Are you a member of any inventor clubs or associations?* Yes No Which club(s) or association(s)?* Do you have a functioning prototype?* Yes No Have you manufactured this idea or any other products in the past?* Yes No Name of Product* Cost of Goods Sold (COGS) per unit* (cost to make one unit packaged)How many have you made to date?* How much inventory do you have sitting now?* Are you paying for storage of the inventory?* Yes No How did you find the supplier who produced the units?* Where is the factory located?* United States Overseas How many units have you sold to date?* What are your total sales to date ($) ?* What Material(s) is the product made of?*FabricMetalPlasticWoodOtherPlease list additional material(s):* Have you filed for a Trademark?* Yes No Are you interested in manufacturing or licensing your idea?*ManufacturingLicensingNot SureHave you shared your idea with any companies?* Yes No Which companies?* To date, how much personal capital have you invested in your idea/product?*Have you borrowed any money?* Yes No How much?*Do you have any partners?* Yes No How many partners do you have?1234+Have you received money from anyone?* Yes No Who have you received money from?* Are they getting any ownership in exchange for funding?* Yes No Is it a loan that needs to be paid back?* Yes No Do you own an existing business?* Yes No Tell us a little bit about your business:* Are you an employee or independent consultant in another business?* Yes No Have you ever paid money to any invention licensing company to help get your product or idea licensed?* Yes No What is the company's name?* Who was your coach or representative from the company?* How much did you pay them?*Have you ever paid money to any invention coach for services?* Yes No What is the coach and company's name?* How much did you pay them?*Have you ever paid money to any invention marketing or invention submission company?* Yes No What is the company's name?* How much did you pay them?*What services did they provide?*Do you have any photos of the product?* Yes No Please Upload Pictures Here:* Drop files here or Select files Accepted file types: jpg, jpeg, png, gif, pdf, Max. file size: 50 MB. Have you created a business plan for this business?* Yes No Have you created a one page product information or sell sheet?* Yes No Upload your info/sell sheet (optional) Drop files here or Select files Max. file size: 50 MB. Who are your competitors?* Do you have any videos of the product?* Yes No Please share YouTube or Vimeo link here:* Do you have a website?* Yes No Please share website URL here:* What's your story behind this product / idea?*How did you find Inventor Rescue?* Have you done a target audience survey?* Yes No How many people participated in the survey?* What did you learn from this survey?* Are you aware of any industry trade shows?* Yes No Please name the show(s)* Have you attended any industry shows for this product?* Yes No Please list the name and dates of the show(s) you attended.* Tell us exactly what specific help you are looking for by checking each box that applies. If a topic you need help with isn’t listed below, click other and tell us exactly what help you are looking for from us.* Proving Your Idea Patent /Trademark/Copyright Attorney CAD Development Prototyping Business Formation Manufacturing Market Research Licensing Website Development Social Media Public Relations Crowdfunding Funding Options Personal Loans Selling on Amazon Coaching Other Select AllOther Area(s) of Assistance Required:* Inventor Rescue Concierge Services* Price: Coupon Total Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20252026202720282029203020312032203320342035203620372038203920402041204220432044 Security Code Cardholder Name Billing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country NameThis field is for validation purposes and should be left unchanged. Δ