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Request form

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Record number Name of requester Postal address with city and country Phone/ Mobile number Email address Type of request Select option Company interested in licensing Knowhow Entrepreneur interested in building a start-up Company seeking a technology solution Scientific/ engineering subject areas relevant to request Select option Life sciences/ biosciences & engineering Chemical sciences & engineering Physical sciences & engineering Mathematical/ computational sciences & engineering Others Investor interest categories relevant to request Select option IT/ITES/Communications Materials Technology including Nanotechnology Biotechnology/ Biomedical/ Health Technologies Clean/Green/ Enviro/Energy Technology Rural/ Social Technology Others Industries relevant to request Select option Afforestation, Horticultlure, Silviculture, Preservation of Endangered Species Agriculture, Agro-biotech, Agro-products, Fertilizers, Food processing & Secondary Agriculture Chromophoric Materials, Dyes, Pigments, Colorants Communications Computing & Electronic Devices. Instrumentation Defense, Aerospace, Atomic Energy (Strategic) Education Electronics, Photonics, Magnetics Energy, Fuels Industrial Biotechnology Inorganic and Hybrid materials, Inorganic materials Medical Biotechnology, Biomed Products, Medical Healthcare, Diagnostics Natural Resources, Water, Environment, Sustainability Organic Chemicals, Fine Chemicals, Intermediates, Feedstocks Petrochemicals and Petroleum Pesticides Pharmaceuticals, Bulk Drugs, Formulations Polymers, Plastics, Elastomers, Fibers, Adhesives, Paints, Specialty Polymers, Natural Polymers, Fibers and Leather Surfactants, Detergents, FMCG Traditional Health Systems Transportation Others Market/ end-user customer categories and nature of business relevant to request Select option Consumers (B2C) Businesses and other industries (B2B) Governments (B2G) Foundations/ NGOs/ Agencies(B2F) Others Your expectation of technology readiness levels for technology request Select option TRL A: Technology concept formulated TRL B: Proof-of-concept demonstrated in lab scale TRL C: Prototype developed and tested; technology demonstrated at pilot scale TRL D: Product or service offering tested in real/ field trials; trial use by test customers TRL E: Commercial production/ service offerings in place TRL F: Proven technology with respect to established market Whether you are seeking patents to be part of technology offering ? Select option Yes No Detailed request

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