Patent Application Form If you have entered this page by error, or wish to exit, click here. * Indicates a required field Salutation Mr. Mrs. Ms. Dr. *First Name Middle Name or Initial *Last Name *Date of Birth Company/Individual E-mail *Phone: Primary       Secondary       Cell Phone Fax *Address Address 2 Address 3 *City *State *Country *Zip Code Co-Inventor 1 Co-Inventor 2 Co-Inventor 3 Names of others authorized to have access to your information. What are the areas or markets for your invention? Who would use it? What is your invention? What are the unique features and benefits of your invention? How is the invention made and used? There are two ways to send us your drawings, sketches, photographs and other information. Mail via secure parcel post to: IP Legal Center 6781 Glacier Dr. West Bend WI 53090 E-mail us with attachments at: patentlaw@iplegalcenter.com Submission of this form does not create an attorney-client relationship, unless or until the Power of Attorney and any fees have been submitted and accepted by this office.