Bright Spark Award

Name: 

Age: 

Parent or carer's name: 

Address: 

Suburb: 

State: 

Postcode: 

Phone - Home: 

Phone – Mobile: 

E-mail address: 

Confirm Email address: 

I confirm that I have read the "Information Sheet for Inventors" attached to this application: 

Yes   No

Patent

Provisional application? 

Yes  No

Number: 

Complete application? 

Standard: Yes  No

Number: 

Innovation: Yes  No

Number: 

Granted patent?

Standard: Yes  No

Number: 

Innovation: Yes  No

Number: 

Please give any other details. eg PCT application

Trade mark: 

Design: 

Name of your invention: 

Invention Website
(if applicable): 

What does your invention do? 

What problem does your invention solve? 

In what industry is your invention intended to be used? 

What stage of development is your invention at?