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SUBMIT YOUR PRODUCT / IDEA CONFIDENTIALLY ONLINE

  
     
       Contact Information  
     
  First Name:         
  Last Name:      
  Phone:       
  Email:  
     
       Product Development  (These 5 easy questions that help us categorize your product development needs)  
     
  1. How can we support your products development?   
       Patent Drawings    Research & Design  
       Prototype               Manufacturing  
     
  2. Do you require a referral to a,  
       Patent attorney?    Yes       No  
       Marketing firm?     Yes      No  
     
  3. How much have you spent in developing this product?     
         $0.00 - $5,000.00  
         $5,000.00 - $10,000.00  
         $10,000.00 or more  
     
  4. Your available budget for developing this product?  
         $0.00 - $5,000.00  
         $5,000.00 - $10,000.00  
         $10,000.00 or more  
     
  5. Do you already have funding for the development of this product?  
        Yes        No  
       If no when do you expect to received funding?    
     
       Product / Idea Information  (a simple description of industry and materials is preferred but not required)  
     
  Product Name:  
     
  Product Description:  
   
     
  I am 18 years of age or older:  
     
  By signing below I understand submitting my product / idea is not a release and that this information will not be used, disclosed, or sold without my written permission.  I believe, to the best of my knowledge, that I am the original inventor or legal owner of the product / idea described above.  I herby authorize BuildMyProduct.com to contact me to discuss my product / idea at no cost and with no purchase required.  BuildMyProduct.com in order to keep an unbiased point of view, does not require or except any royalties or partnership agreements. I understand that BuildMyProduct.com does not promise any financial gain from development of any new product / idea.  
     
  Initial Here if you have read and understand the agreement above:  
     
   
     
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