Software Disclosure Form

Foip Statement

The personal information requested on this form is collected under the authority of Section 33 (c) of the Alberta Freedom of Information and Protection of Privacy Act (“Act”) and will be protected under Part 2 of the Act. The information is collected for the purpose of recognizing an Software Disclosure, and to further contact the applicant.  
 
If you have any inquiries in regards to the collection of your personal information, please direct those inquiries to:  FOIP Coordinator, University of Lethbridge, 4401 University Dr. West, Lethbridge, Alberta T1K 3M4, telephone: 403-332-4620, email: foip@uleth.ca.
If you have any inquiries in regards the Software Disclosure Form or any other University-Industry Liaison (UILO) programs & forms, please direct those inquiries to: Greg Vilk, UILO Manager, University of Lethbridge, 4401 University Dr. West, Lethbridge, Alberta T1K 3M4, telephone: 403-317-2860, email: greg.vilk@uleth.ca

Purpose

This secure and confidential disclosure form is your first step in the innovation process if you have designed unique software which may have potential commercial and social application. Any early-stage discoveries of this nature which are common in leading-edge world-renowned Institutions such as the University of Lethbridge are initially disclosed to the UILO office via the Software Disclosure Form (SDF) for review on:

  • The stage of development
  • Commercial potential
  • Market potential
  • IP protection strategy
  • Capital requirements for successful commercialization
  • Other pertinent translatable strategies

to mobilize your creative knowledge for society’s benefit.  With deep and applied expertise in commercialization, the UILO professionals are there to work together with you to build and sustain your commercialization endeavors either through licensing, partnering or new company formation.
 
The SDF helps you communicate your early-stage innovative findings so our team can quickly evaluate its potential.
 
Start today so we can begin the journey together!

1. Software
2. Principal Inventor

Note to Principal Inventor:

  • If more Co-Inventors, please add co-inventor attachment below.
  • If tenured from another institution, but U Lethbridge adjunct or affiliated, please indicate.

It is the responsibility of all inventors to keep the University-Industry Liasion Office informed of address changes

3. Co-Inventor(s)
Co-Inventor 1
Co-Inventor 2
Co-Inventor 3
Co-Inventor 4
Co-Inventor Attachment
Principal Inventor Agreement
4. Software Details

For the Software Disclosure Form (SDF) , The University of Lethbridge will reserve the right to share information in this SDF on a confidential basis, as part of an inter-institutional agreement. The University of Lethbridge is committed to the protection of all personal information in accordance with the principles set out in the provisions of the University's Guidelines/Policies. PIPEDA and the Freedom of Information and Protection of Privacy Act of Alberta in regards to Access to Information and Protection of Privacy. The University will comply with PIPEDA, The Freedom of Information and Protection of Privacy Act of Alberta and with respect to all personal information collected, used or disclosed by it in the course of commercial activities.

Software Information

Provide details about the software. What does it do? Please attach sketches, drawings, photographs, screen prints and other materials to help illustrate the description.

9. Development History
A - Initial Idea
B - First successful version
C - First publication (article, thesis, oral presentation, abstracts, poster)
D - Industry Disclosure(s) identified
E - Other disclosures
G - Are your lab books and other records in order and available?

The records produced based on this document contains information that would reveal trade secrets of the Contributor(s) or commercial, financial, scientific or technical information of the Contributor(s) that is supplied in confidence, the disclosure of which could be expect to either:

  • Harm significantly the competitive position or interfere significantly with the negotiating positon of the Contributor(s) or their Agent(s); or
  • Result in similar information no longer being supplied to the Univeristy when it is in the public interest that similar information continue to be supplied; or
  • Result in undue financial loss to the Contributor(s).

Accordingly, except as required by law or as otherwise permitted pursuant to the terms of this Document, neither the University nor the Contributor(s) will disclose the contents of this Document or the foregoing records other than:

  • For the purpose of implementation or enforcement of the same; or
  • A general statement on the parties to the Document and the Title of the Technology, either party being entitled to publish that information.

Once completed and submitted, please forward any additional documentation to:

Univeristy-Industry Liasion Office
Office of Research and Innovation Services
The University of Lethbridge
Room B634, University Hall
Lethbridge, AB, Canada T1K 3M4

* Within 30 days of receipt of this Software Disclosure Report, a meeting with the University-Industry Liasion Manager will determine whether additional information (detailed disclosure) is required.