Equalizer Service and Repair Form

Project Invention Interest Form
Name

First NameLast Name
Phone Number
Company Name
Email
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Please tell us a brief description your idea.
Image or video upload:

Cancelof
Do you have a prototype of your idea made?
Have you tested your prototype in the field?
Have you sold your tool idea to anyone?
Do you have a patent or patent pending?
Patent Number
By signing below, I agree that I have submitted my idea to Equalizer® on a non-confidential basis and its’ submission does not obligate Equalizer® in any way. I understand that upon submission of my idea, Equalizer® will review and consider whether Equalizer® desires to offer me an award, royalty contract...etc. to use the idea. In the event I do not enter into a contract with Equalizer®, I understand that Equalizer® assumes no obligation and that any claim which I may have shall be based solely upon patent rights I might now have or will obtain on my idea.
Should be Empty:

Project Invention Interest Form