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Innovation Connection Technology Product Application Your product(s) are important to us. Please provide the following information And all required collateral material with new product submissions
Submit Completed Form to: Patterson Technology Center [email protected] Company Name: Phone: Product Name: Address: E-mail: City/State/Zip: Web Site: Are we currently doing business with your Are any of your products sold by other Company? Yes No Patterson Companies subsidiaries? Yes No If Yes, please explain If Yes, please identify which: Which market/s is your product applicable? Sample Marketing Brochures attached to this form Dental Yes No Ortho Yes No Yes No Veterinary Yes No VENDOR INFORMATION Contacts: (Name, Title) Contacts: (Phone, Email Address) Primary Business: Phone: Email: Primary Technical: Phone: Email: Primary Marketing: Phone: Email: Other Contact(s) Phone: Email: Revision 6.5 Innovation Connection Product Submission Form 1 of 3 CONFIDENTIALPrinted copies of this document are considered uncontrolled
6595.1.Rev003 09.14.2016 How many years has the company been in What marketing activities are planned for this business? product? (Ie: trade journal ads, distributor ads etc.) How are you currently distributing your Does company have field sales products? representation? Yes No Dealer Direct If yes, what type of field sales representation: Other: Dedicated Independent How many customers do you have actively Number of employees in the company? using your product? PRODUCT INFORMATION Asterisk after number indicates field must be completed in order for product to be considered
1*. Product name (include trademarks, etc): 2*. Product market Introduction Date: Product availability Date: 3*. Product description: 4*. What is the retail price of the product/service? 5*. Is there recurring revenue from this offering? 6*. What products, currently on the market compete with this product? 7*. How many customers do you have using your product? 8*. Does your company have a patent for this product? 9*. Is this product a medical device? Yes No If yes, must indicate or provide all that apply: 1) Product Medical Device Listing number: 2) Product 510K number: 3) Manufacturer Facility FDA Establishment Number: Revision 6.5 Innovation Connection Product Submission Form 2 of 3 CONFIDENTIALPrinted copies of this document are considered uncontrolled
6595.1.Rev003 09.14.2016 4) CE marked: Yes No If yes, date applied: 5) FDA Approved? Yes No Submitted by: Date: Phone/E-mail: PATTERSON INTERNAL USE ONLY Product evaluated by: ___________________________________ Date: _________ Notes: ______________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Item approved to add by: _______________________________ Date __________ Revision 6.5 Innovation Connection Product Submission Form 3 of 3 CONFIDENTIALPrinted copies of this document are considered uncontrolled
Sample Marketing Brochures attached to this form Yes No VENDOR INFORMATION Contacts: (Name, Title) Contacts: (Phone, Email Address) Primary Business: Phone: Email: What …
Innovation Connections is part of AusIndustry’s Entrepreneurs' Programme, which transforms Australian businesses by providing access to expert advice and grants. access grants to make it happen (from $20,000 to $1 million). At the heart of the program lies our national network of facilitators.
You can apply for Innovation Connections at any time. What you get? You’ll be paired with an independent facilitator. Your facilitator will make recommendations for your research project, connect you with research institutions and help you apply for a grant to fund your researchers. Who is this for?
You may need to commit resources such as staff, facilities or equipment depending on the nature of the project. To speak to someone about your specific circumstances, contact an Innovation Facilitator in your state .
20 Examples of Innovative Technology Designs Table of Contents 1. SA950 3D MONITOR BY SAMSUNG 2. Wireless Charging Technology From Ecoupled 3. TROMM Styler Clothes Steamer 4. U-Socket AC and USB Power Outlet 5. Touch Mouse by Microsoft 6. Lady Gaga’s Polaroid Camera Glasses 7. Nomad iPad Paint Brush Stylus 8. iRobot Scooba 230 Floor Washer 9.