Partnership Meetings Speaker Interest Form

OMB Control No. 0651-0080
Expiration Date: 08/31/2018

We are interested in hearing from you. To participate as a CPM speaker, please fill out the form below. All items with “*” are required.

(spaces/hyphens may be used)

(Select all that apply)
TC 1600 Biotechnology/Chemical/Pharmaceutical Customer Partnership Meeting – Biotechnology and Organic Fields
TC 1700 Customer Partnership Meeting – Chemical and Materials Engineering
TC 2400 Cyber Security Customer Partnership Meeting
TC 2600 Customer Partnership Meeting - Communications
TC 2800 Semiconductor Customer Partnership Meeting - Semiconductors, Electrical and Optical Systems and Components
TC 2900 Design Day - Designs
TC 3600 Business Methods Customer Partnership Meeting - Electronic Commerce, Licensing and Review
TC 3600 & 3700 Customer Partnership Meeting - Transportation, Construction, Agriculture, Mechanical Engineering, Manufacturing and Products
Partnering in Patents - in collaboration with all TCs and AIPLA
No preference

(Select all that apply)
Alexandria, Virginia
Dallas, Texas
Denver, Colorado
Detroit, Michigan
San Jose, California
Virtually via WebEx


The United States Patent and Trademark Office (USPTO) is conducting this poll to gather information from stakeholders interested in speaking at a customer partnership event. This poll is strictly voluntary, includes 5 questions and should take approximately 3 minutes to complete. This information collection contains requirements subject to the Paperwork Reduction Act (PRA). Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subject to penalty for failure to comply with, a collection of information subject to the requirements of the PRA, unless that collection of information displays a currently valid OMB control number.

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