Japanese / English

Submit proposal for licensing

Please fill out the following form and click the ″Confirm″ button.

Your Information

Name 【Required】

Company / Organization name 【Required】

*Please fill in Organization Name and department / classroom / course.

Contact information 【Required】

■Telephone

Location (Head office) 【Required】

■Postal code
■Address
■Country Name

Website

Material Information

Product name 【Required】

Classification

*Please check the appropriate classification(s).

Stage of clinical development

*Please select the appropriate stage.

Disease area

Expected indication

Mechanism of action

Advantage of the product

Attachments 【Required】
*File Size: Total 2MB

*Template / other; either is acceptable.

Intellectual property

Desired contract type