(A Non-Profit Educational Corporation)



 Oklahoma Inventors Congress
 P.O. Box 0204
 Edmond, OK.    73083-0204


I, the undersigned, apply for membership as a regular member of the Oklahoma Inventors Congress and
enclose  payment in the amount of $25.  If accepted for membership, I hereby promise to abide by the
Constitution and by-laws of the organization, and assist, to the best of my ability, in furthering its goals.

I agree that I will not in any way make, use, sell, divulge, duplicate or capitalize on an idea or invention not mine.
  Further, I will not be a cause to such actions as a result of ideas and/or inventions disclosed in confidence by
a fellow member without first obtaining the signed approval of the originating inventor.  If such does occur,
mutually beneficial and protective contractual agreements are to be made and signed by the inventor and
others involved in the transaction prior to such use.  This agreement is challengeable only to the extent that I
can satisfactorily demonstrate with documentary proof that the information disclosed had been previously
known to me.


My full name is: (Please Print or Type)

My mailing address is:

City   State    Zip Code 

E-Mail Address  

Web Site Address  

I may be reached by telephone at: 

during the Day   or    Evening

                          Signature: _________________________________

Please enter an "X" in the appropriate box(es)

I am interested in:   Creative Thought    Idea Development    The Patent Process    Helping Others

I presently have:      An idea, which may result in a new invention     An invention     The desire to invent

My idea/invention is:      Mechanical    Electrical    Chemical    A Process    Horticultural    

The status of my idea / invention / desire is:  Idea Only   Sketch(s)  Some Drawings   Full Drawings  

I have made or constructed:      No Model       A Non - Working Model         A Working Prototype

My idea is protected by:    Secrecy    A Filed Disclosure Document   A Filed Patent Application  
U.S. Patent(s)
   Foreign Patent(s)    U.S. Patent Number(s)

I need assistance in:   
Idea Development
    Prototype Development  Patent Research    Marketing     Venture Capital
 Patent Application
   Manufacturing      Business Planning       Engineering      Liability Insurance  

I have expertise in the following field(s):  

I can assist other members with:

If accepted for membership, I will be willing to serve on committee assignments at the:
Local Chapter Level
   State Level   National Level   International Level    No Committees  

Enter additional information or comments in the space provided below:

SPONSORING AGENCY:  The Office of the Governor; The Oklahoma Center for the Advancement of
Science  and Technology (OCAST); Inventors Assistance Service, (IAS).                                  ŠOIC 2009

The Oklahoma Inventors Congress is a member of the United Inventors Association of the United States of America
and is recognized by the World Intellectual Property Organization (WIPO) of Geneva, Switzerland.


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