Hills Pitch Day University Project application form Please complete this application electronically and save and submit by the closing date Friday 10 April, 2015. Please note: If your application is successful, you will be expected to pitch your idea at the ‘Hills Pitch Day’ on Thursday 7 May, 2015 in Adelaide. (Note: Any expenses incurred in traveling and presenting your idea will be your responsibility.) University Project application form process All University applications from Flinders University, UniSA and University of Adelaide are to be submitted via the University contact points who will then submit them on your behalf to Hills. Any university applications submitted directly to Hills will not be considered. Hills will confirm by 28 April, 2015 if the application has been successful to attend Hills Pitch Day. Contact Points: • Flinders University Matt Salier, 08 8201 7522 matt.salier@flinders.edu.au • University of Adelaide Dr Jane Rathjen 08 8313 6009 jane.rathjen@adelaide.edu.au • UniSA Jasmine Vreugdenburg, 08 8302 5477 hills@unisa.edu.au Instructions on how to name and save your application form DSU_ProjectName_ContactName • DSU = D-Shop required / University Project • Project Name = Name of Project being submitted for assessment • Contact Name = Principal contact name LHU_ProjectName_ContactName • LHU = Lance Hill Design Centre required / University Project • Project Name = Name of Project being submitted for assessment • Contact Name = Principal contact name 1 Detailed application information 1. Please provide the following contact details: Project name: Please provide an email address so we can get in touch with you. Please provide your team lead contact name and contact number. Please provide a Skype ID 2. Describe your innovation / idea / project. 3. What “pain point” or “problem” is it trying to solve or what need is it meeting? 2 4. What market segment or industry does your project target? 5. Have you assessed how large the market potential / market size is in Australia or globally? 6. Do you have a prototype, demonstration or website? If yes, please provide information. 3 7. Has any user centred design research been conducted? If yes, please provide information. 8. What is unique or innovative about your project and why does it have an advantage? Is there a current solution or other competitors in the market offering a similar offering? 4 9.Do you have any registered Intellectual Property (IP) assets (such as patents, designs or trade marks) that relate to the project/concept/idea? If so, please provide details of the IP assets? 10.Have you conducted any searching in relation to the project/concept/idea, i.e. novelty/patentability searching and/or freedom to operate/infringement searching? If so, can you please provide details of any searches that have been carried out, including information relating to the aim of any searches that have been done, the parameters or scope of any searches that have been done, details of who performed the searches, and whether you have any search results to provide. 5 11.What aspects or features of your project/concept/idea do you consider to potentially be protectable by way of registered IP assets (i.e. by way of patents, trade marks or designs)? 12.Does your project/concept/idea incorporate any ‘off the shelf’ components? If so, can you provide details of where you have sourced the components from? If your project/concept/idea does incorporate ‘off the shelf’ components, what proportion of the overall project/concept/idea would you say the ‘off the shelf’ components are compared with technology you have developed? 6 13.Has the project/concept/idea been sold, offered for sale, publicly disclosed or displayed, subjected to publication, advertised, tested with supervision, tested without supervision or used? If any of these situations has occurred, please provide details. 14.Does any person or company own any interest or percentage in the project/concept/idea? If so, please advise the name of that person or company. 7 15.Can you identify any companies or individuals who may be producing potentially competing products? 16. How long do you believe it would take you to commercialise your product? 8 17.Is your project for the Lance Hill Design Centre or the D-Shop? 18. Can you please detail what funding, tools or support is required? 9 19.Of the total funding requested, please break this cost down into major milestones / deliverables and key dates these milestones would be expected to occur? Specifically how much funding is requested and for what specific activity within each milestone development. 20. Will you require prototyping support of any hardware design during the project? 10 21.Have you received any other funding for this project before, or are there any other interested parties or collaborative partners that Hills should know about? Please provide details. 22. What possible additional assistance do you require from Hills to ensure the success of this project? 11 23.To receive Hills Innovation Centre funding, it is a requirement that project teams work from the Hills Innovation Centre in Adelaide for at least 20% of the project duration. What are your expectations from working with the Hills Innovation Centre with regard to support provided to you by Hills? 24. Has this project generated any revenue to date? 12 25. Does your product aim to generate revenue via product sales or charge for a recurring service? 26. Would you be opposed to combining/collaborating with others? 13 27.What are your expectations regarding what entitlements Hills will have in the venture/business going forward? 28. Please tick which segment your project applies to. (Can be more than one in each category.) A. Solution Verticals: B. Product Characteristic: C. Market Segments: Health & Aged Care IP based Government Assisted Living Open Standards Enterprise Lifestyle & Well Being Hardware Business Security & Safety Software Home Data Analytics Cloud Based Automation & Smart Home Other – please specify Other – please specify Other – please specify 14 Project Team Information Has your team commenced this project? How many team members does your project have? Which collaborating partner do you represent? What are the roles and capabilities of each team member? Has this team or members of this team built other products? Please provide information or evidence to support this. 15 Innovation Centre General Disclaimer Application You agree that: a. You are responsible for your application (“Application”) and all of its contents and you provide your Application at your own expense and risk. b. Submission of your Application and Hills review of it does not constitute acceptance of your Application or any contract of employment with Hills. c. We may accept or reject your Application in our sole and absolute discretion without providing reasons. We also reserve the right in our sole discretion to reject your Application at any time including after initial acceptance by Hills. We are not obliged to enter into any further agreement or discussion with you following submission of your Application. Confidentiality a. We will treat the contents of your Application as confidential and, except as specified in these terms and conditions, we shall not disclose details of your Application to any person other than to our Related Bodies Corporate (as defined in the Corporations Act 2001 (Cth)), their employees, officers and agents as reasonably necessary for the purpose of evaluating and progressing your Application, members of the South Australian Government, members, employees and/ or representatives of UniSA, University of Adelaide, Flinders University and DSTO or as otherwise required by law or any binding rules or regulations. b. Any Personal Information (as defined in the Privacy Act 1988 (Cth)) you provide to us in your Application will be dealt with in accordance with the Hills Privacy Policy, a copy is available by clicking here. Intellectual Property a. Nothing in your application shall be construed as granting or conferring on us any proprietary rights, licences or other rights in your Application, other than the rights expressly granted to us under these terms and conditions. b. You confirm that your Application is original and does not infringe the rights of any person. c. You indemnify and hold us and our Related Bodies Corporate, employees, officers and agents harmless in respect of any loss, damage, liability, claim or expense arising out of or in connection with any claim including any claim that your Application infringes the intellectual property rights of any third party. Hills Pitch Day Application Disclaimer & Acknowledgement I have read the disclaimer set out and agree to its terms. I acknowledge that my Application is accepted by Hills on the basis of the disclaimer. 16
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