PROFORM® Engine Performance ©2006-2008

Idea Submission Form - Click here to print

NON-CONFIDENTIAL IDEA SUBMISSION FORM

Print this form, fill it out completely, and mail it to; Product Development Dept.,
Specialty Auto Parts U.S.A., Inc., P.O. Box 306, Roseville, MI 48066, USA.

Personal Information

	Full Name:
	______________________________________________________________________________

	Mailing Address:
	______________________________________________________________________________

	City, State, Country, Zip:
	______________________________________________________________________________

	Home Phone:
	______________________________________________________________________________

	Business Phone:
	______________________________________________________________________________

	Fax Number:
	______________________________________________________________________________

	Email Address:
	______________________________________________________________________________

	Present Employer's Name and Mailing Address:
	______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

	Present Employer's City, State, Zip, and Phone Number:
	______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

	Name and address of the Employer at the time you conceived the idea:
	______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

	City, State, Zip, and Phone Number of the Employer at the time you conceived the idea:
	______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

	Does either employer have any right to the idea? YES_____ NO_____

	List the names and addresses of others that have rights to this idea (if not applicable, write N/A).
	______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

About Your Idea

	Describe your idea, providing enough information so that we can determine whether or not this idea is one we wish to consider. Please print or type - attach additional sheets if necessary.
	______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________

I have read and understand the Conditions and Procedures Regarding the Submission
of Ideas to Specialty Auto Parts U.S.A., Inc. and agree to these conditions and procedures,
particularly those listed in the Legal Agreement. I confirm the above idea description
does not disclose any confidential or proprietary information, and that all information
provided with this submission is non-confidential. In addition, Specialty Auto Parts U.S.A.,
Inc. may copy or retain any samples, drawings or documentation that are submitted with
this Agreement.

	Print Name of Submitter: Date: _________________________
	______________________________________________________________________________

	Signature of Submitter:
	______________________________________________________________________________

	Address of Submitter:
	______________________________________________________________________________

	City, State, Country, Zip of Submitter:
	______________________________________________________________________________

	Print name of Guardian (if Submitter is under 18 yrs. old):
	______________________________________________________________________________

	Signature of Guardian (if Submitter is under 18 yrs. old):
	______________________________________________________________________________

If a copy of an issued or pending patent does not accompany your idea submission, you are required to complete the Supplemental Idea Information form.

Go to the Supplemental Idea Information form

PROFORM and Factory Performance Parts are registered trademarks of Specialty Auto Parts U.S.A., Inc.
General Motors Trademarks used under license to Specialty Auto Parts U.S.A., Inc. License No. 27-2401-51955.
Some parts are not legal for use in California or on any pollution controlled vehicle
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