Northeast I-Corps Hub Team Application

Northeast I-Corps Hub Team Application

NSF I-Corps Hub: Northeast Region

Team Information

What is your team's name?

City

State/Province

How many people are currently on your team? (1-5). You will enter each person's info one-by-one.

Explanation of Roles

Teams consist of at least an Entrepreneurial Lead (EL) and a Technical Lead (TL):

Entrepreneurial lead

The entrepreneurial lead may be a graduate student, postdoctoral scholar, undergraduate student or staff member with relevant knowledge of the technology or market and a commitment to investigate the potential opportunity for commercialization.
The role of the entrepreneurial lead is to drive the customer discovery process and support the transition of the technology into the marketplace if it demonstrates commercial viability.

Technical lead

The technical lead will often have been involved in creating the technology that forms the basis of the team’s business concept or possesses a high level of relevant technical expertise. The role of the technical lead is overall project management. The technical lead is often a faculty member and, if a company is formed, plays a key leadership role such as a scientific advisor or chief technical officer.

Industry Mentor

The industry mentor will typically be an experienced entrepreneur, intrapreneur or corporate innovator who serves as a third-party resource.
The role of the mentor is to guide the team forward and track progress.
Teams do not have to identify an industry mentor prior to application, but are encouraged to do so.

Co-ELs, co-TLs and co-IMs are allowable, as long as all are active I-Corps team members.

Applicant Information

Team Role

First Name

Last Name

Email Address

Phone Number

Academic Institution (if you are not applying as an Academic Team, please provide your company name)

Please Specify

Current University Status

School/Department

Qualifications/Experience: What qualities/expertise you bring to the team regarding this technology/innovation ?

Applicant Information

Team Role

First Name

Last Name

Email Address

Phone Number

Academic Institution (if you are not applying as an Academic Team, please provide your company name)

Please Specify

Current University Status

School/Department

Qualifications/Experience: What qualities/expertise you bring to the team regarding this technology/innovation ?

Applicant Information

Team Role

First Name

Last Name

Email Address

Phone Number

Academic Institution (if you are not applying as an Academic Team, please provide your company name)

Please Specify

Current University Status

School/Department

Qualifications/Experience: What qualities/expertise you bring to the team regarding this technology/innovation ?

Applicant Information

Team Role

First Name

Last Name

Email Address

Phone Number

Academic Institution (if you are not applying as an Academic Team, please provide your company name)

Please Specify

Current University Status

School/Department

Qualifications/Experience: What qualities/expertise you bring to the team regarding this technology/innovation ?

Applicant Information

Team Role

First Name

Last Name

Email Address

Phone Number

Academic Institution (if you are not applying as an Academic Team, please provide your company name)

Please Specify

Current University Status

School/Department

Qualifications/Experience: What qualities/expertise you bring to the team regarding this technology/innovation ?

Team History

How did the team meet ?

How long have you worked together ?

How does the team work together now ?

How did you hear about the I-Corps Hub Northeast
Regional program (please specify in the text box)?

Info Session

Email

Newsletter

LinkedIn

Other Social Media

Please Specify

Conference or Event

Please Specify

Faculty Lead

Please Specify

Previous I-Corps Team participant

Please Specify

Tech Transfer Office contact

Please Specify

Other Friend or Colleague

Please Specify

Technology/Innovation Origin and Source

The origin of this technology/innovation comes from which of the following Hub Institutions?

Please Specify

The origin of this technology/innovation has been developed from

Please Specify

Technology Topic Area (chose any that apply)

Advanced Analytics	Advanced Manufacturing
Advanced Materials	Artificial Intelligence
Augmented and Virtual Reality	Biological Technologies
Biomedical Technologies	Chemical Technologies
Cloud and High-Performance Computing	Cybersecurity and Authentication
Digital Health	Distributed Ledger
Energy Technologies	Environmental Technologies
Human-Computer Interaction	Instrumentation and Hardware Systems
Internet of Things	Learning and Cognition Technologies
Medical Devices	Mobility
Nanotechnology	Other Topics
Pharmaceutical Technologies	Photonics
Power Management	Quantum Information Technologies
Robotics	Semiconductors
Space	Wireless Technologies

Please include any relevant research awards or funding

related to the development of this technology:

NSF (National Science Foundation)

NIH (National Institutes of Health)

DOE (Dept of Energy)

DoD (Dept of Defense)

Corporate / Industry Sponsored

Please Specify

Other

Please Specify

Unsure

What is the status of the Intellectual Property (IP) of this

innovation?

Not disclosed to Tech Transfer Office

Disclosed to Tech Transfer Office

Provisional Patent Application filed

Regular Patent Application filed

Patent Issued

Other

Please Specify

Unsure

Please answer the questions below.

Who is the assigned Licensing

Manager? (If unsure, put "Unsure." If no

IP protection, put N/A)

Please list any relevant patent, patent

application numbers, or disclosure

reference number related to this

innovation.

Note: For information about invention disclosures, please speak with your university Tech Transfer Office or email us at info@icorpsne.org.

Technology Description & Commercial/Business Concept: Please provide a short non-technical description of the technology. (DO NOT DISCLOSE ANY CONFIDENTIAL OR PROPRIETARY INFORMATION!! If in doubt, please contact your Tech Transfer Office before submitting the application).

Customer Discovery Plan: We expect you to come to the program with a rough plan for meeting with 15+ potential customers, spending ~8-10 hours per week over the 4 week Northeast I-Corps Hub program. What industries are you looking to explore to conduct your interviews? Please state any upcoming trade shows, conferences (virtual or in-person), meetup events (if so, give expected dates and locations) that you are planning to attend. If selected, your team will receive funding for Customer Discovery activities such as these.

Market Opportunity for the Technology: Describe your idea for a product/service that can be developed from this technology? Who do you think would purchase it, use it, or benefit from its introduction into the market? What competitive advantages does your innovation have over the existing technology?

Team Goals: Why do you want to participate in the Northeast I-Corps Hub program? What do you hope to learn? What outcomes do you hope to achieve?

By submitting this application you are confirming that all team members agree to make every reasonable effort to attend all training sessions associated with the program and complete deliverables and required surveys in a timely manner. Please select your team role and type your name to signify your signature. Once complete, please click Submit.

Entrepreneurial Lead

Technical Lead

I-Corps Team

Institution

Contact Information