Academic IP Assignment Form
1. Assignor Details
Name
Institution/Department
Email
Phone
2. Invention/Work Details
Title
Description
Date of Creation/Discovery
3. Co-Inventors/Authors
Name
Role
Email
4. Assignment
I, the undersigned, assign to the Institution all rights, title, and interest in the above invention/work and associated intellectual property.
Signature
Date
5. Institution Approval
Name
Title/Role
Signature
Date