Student Ideas for a Better America™ Submission Form

How to Submit Ideas

1. Student must be a U.S. citizen.
2. Complete the Submission Form. Incomplete submissions will not be considered.
3. Complete the questions describing your idea/invention fully.
4. Include labeled & colored drawings, diagrams, etc.
5. Consider an optional photo or video.

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I. Student Information

Name

First Name

Last Name

Date of Birth (M/D/Y)

Grade

Address

City/Town

State/Province

ZIP/Postal Code

Phone

II. School Information

School Name

School Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Teacher/Mentor

Teacher/Mentor First Name

Last Name

Suffix

Phone

III. Method of Contact

If selected to win, contact:

IV. Invention | Idea Information (In student's own words)

Invention Name

Invention name is original and is not used for another product/service?

(*Required for Gr4-8 and Gr9-12)

Did you A) conduct an internet search to see if your invention already exists and B) visit http://www.uspto.gov/patents-application-process/search-patents to see if a U.S. Patent for a similar item already exists?

(*Required ONLY for Gr9-12)

If "NO," your submission will be considered INCOMPLETE.

Is your invention an original idea that does not currently exist or have a U.S. Patent? (*Required ONLY for Gr9-12)

Describe what your invention or idea is:

Explain how it works:

Is it an improvement upon an existing invention? (*Required for Gr4-8 and Gr9-12)

If yes, name the existing invention you are improving: (*Required for Gr4-8 and Gr9-12)

If yes, describe how you improved the existing invention: (*Required ONLY for Gr9-12)

List materials needed to make your invention:

Include a drawing, photo, and/or upload a video to YouTube (For YouTube upload instructions, visit: https://support.google.com/youtube/answer/57407?hl=en). Provide YouTube video link below.

Upload requirements

YouTube link if applicable:

Were you able to create your invention?

If yes, how well did it work?

If your invention did not work well, what improvements are necessary?

V. Resources (You may leave blank if no resources used)

If you received help answering these questions and/or building your invention, list who helped:

If you used any references (books, articles, online sources etc.) list them below. *Grade 9 - College students should follow APA format. For APA guidelines visit: https://owl.english.purdue.edu/owl/resource/560/05/

VI. Submission Checklist

I have completed all information in sections I-V, using complete sentences and in my own words?

I have conducted online research to see if a similar invention or U.S. Patent exists? (*Required ONLY for Gr9-12)

I have included photos, drawings, and/or the YouTube link to my video?

I have listed references used (books, articles, websites)?

VII. Signature

Use the "tab" key to advance between fields for signing and dating.
You can also click "tab" to advance to the SUBMIT button. Press "ENTER" when the SUBMIT button is highlighted.

Student Signature

Date

Parent Signature (If student is under age 18)

Date

Teacher/Mentor Signature

Date

Submission Help Use the "tab" key to advance between fields for signing and dating.

You can also click "tab" to advance to the SUBMIT button. Press "ENTER" when the SUBMIT button is highlighted.

Student Ideas for a Better America™ Submission Form

Student Ideas for a Better America™ Submission Form

How to Submit Ideas

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