TALA INDIVIDUAL PATENT MEMBERSHIP APPLICATION

This form is only for new members to TALA’s patent pro bono program for inventors. If you are an artist, please use our artists new and renewal forms. 
Program Eligibility Information



Financial Information
Please note that applications cannot be considered without the following information:



What is your Household size?






Member Information

















The information below is not required and you may select “Prefer not to answer”.  Eligibility for TALA programs is not affected by your answers to these questions. The answers to the following five questions will only be used in the aggregate for reporting purposes.

USPTO 551 (Rev.4/7/23) Approved for use through 04/30/2026. OMB 0651-0082 U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE

Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB Control Number. Response to this information collection is voluntary; however, the data collected from this survey will be used to evaluate and publicize the Patent Pro Bono Program. Any comments on the amount of time you require to complete this survey and/or suggestions for reducing this burden, should be sent to the Chief Administrative Officer, United States Patent and Trademark Office P.O. Box 1450, Alexandria, VA 22313-1450.






Invention Details
In filling out the information below, do not include proprietary or confidential information about your invention. 

Please enter N/A if you were not employed

Please select "No" if you were not employed





Payment Information
Your card will be charged $100 for the TALA membership fee. 





Contact Information