Welcome to Technology Transfer

Licensing Interest Form

If you are interested in licensing one of our technologies, please complete the following form. The information requested provides the Lab with information about your capabilities and resources to commercialize the technology.

*Required for initial inquiry

Contact Information

Name:
*
Title:
*
Company/Organization:
*
Mailing Address:
*
E-mail:
*
Phone:
*
Date:
*

*Technology of Interest

List the name (s) of Thomas Jefferson National Accelerator Facility's technology of interest:
*

Does any foreign entity (company, person, foreign government, etc.) have a controlling interest in the company?

Select license type:

How did you learn about the technology?

Provide a brief description of your business/organization

Summarize your organization's relevant technical expertise and experience in commercializing early stage technology (or a citation to a specific web page containing such information).

Additional comments:

Submit this form and any attachments to:
Rhonda Scales, Legal Counsel
mailto:scales@jlab.org

Technology Transfer

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Welcome to Technology Transfer

Licensing Interest Form