Entry Form

Only UIA members will be considered for this contest. If you are not a UIA member yet, click here to join and receive 10% off when you enter this special discount code: AbNewUIA. We encourage all inventors to join this national non-profit dedicated to education and support.

Download the Entry Form (PDF) or complete the online form below:

Inventor

Name:
Street:
City:
State/Province
Zip/Postal Code
Home Phone:
Mobile Phone:
Email:
UIA Member #:

Invention

Invention Name:
Patent Number:
Briefly describe your invention:
Who is the target (the likely purchaser) for your invention... and why?
What issue or problem does your invention address?
How and why is your invention better than other products already available?

Invention Image

We encourage you to submit a visual representation of your invention, even if just a rough sketch. You may upload an image file here, or send one separately. Please include your name and your invention's name in the document.

Invention Image:

Signature

I declare that I am the inventor of the invention herein described, that all information provided is true to the best of my knowledge, and that I have read and accept the attached terms and conditions.

Inventor's Signature:
Date: