Name* First Last Job Title*Company/Employer*Date Date Format: MM slash DD slash YYYY Email* PhoneName of Product Idea*Description of Idea*Who in the industry would benefit from this product?*Advantages of Idea*Is their a similar product on the market?*YesNoWhat is it similar too?(Products/Manufacturer)Have you spoken to any other Manufacturers about this idea?*YesNoWhat manufacturers and what was discussed?What would you pay for this product?*Other notes or comments