UNIVERSITY INTELLECTUAL PROPERTY AGREEMENT
FORM INSTRUCTIONS

Form Instructions

1. Status Check Boxes - Select one of the following nine options:
• Faculty/Staff
• Graduate Assistant/Fellow/Trainee
• Graduate Student
• Undergraduate Student
• Postdoctoral Trainee/Research Associate
• Visiting Scholar/Scientist/Student
• Emeritus/Retired Faculty
• Non-Degree Student
• Other
2. Other - If "other" selected above, provide details
3. PSU ID - Enter the PSU ID number.
4. Name - Enter the Last name followed by the first name of the individual
5. College/Department/Admin - Enter the College, Department, or Administrative Unit of the individual
6. Witness - Enter the name of the witness
7. Witness College/Department/Admin - Enter the College, Department, or Administrative Unit of the witness.

The individual must sign and date the form in the presence of the witness. Once signed by the individual, the witness then signs and dates the form.