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2021年中关村论坛国际技术交易大会“全球产业创新领先技术百强榜单”评选活动为中关村论坛品牌活动之一，以促进技术交易合作为目标，在中关村科技园区管理委员会的指导下组织举办，面向全球征集遴选并最终发布全球前100强产业创新领先技术榜单，经100位中外专家评审团三轮评选，最终形成100项最具价值、最具创新影响力的产业创新领先技术，于2021年中关村论坛国际技术交易大会期间重磅发布，并将作为重点合作项目获得各种推荐机会。
主办单位：国际技术转移协作网络（ITTN）
协办单位：医疗器械创新网
医疗器械产业技术创新战略联盟
中国医疗器械行业协会创新服务专业委员会
报名对象：参加2019-2021年度医疗器械创新网（www.innomd.org）的获奖项目
报名截止时间：2021年7月31日
报名方式：下载填写报名表报名（限额30个项目）
申请资料发送邮箱：storyw@163.com
报名咨询：王临13701192397 微信同手机号
2021中关村论坛—技术交易发布大会“产业创新领先技术百强榜单”
2021 International Technology Trade Fair and Release on ZGC Forum
“100 Best Industrial Innovations for International Technology Transfer”
作为项目方向组委会做出承诺和申明如下：
一、参与承诺
本人代表所发布技术项目，自愿参加2021中关村论坛技术交易大会产业创新领先技术百强项目榜单评选活动（以下简称“活动”），并向活动组委会作如下承诺：
（一）承诺人提供的所有资料（包括并不限于所在单位和团队成员信息、项目文件、路演信息等）所含内容均真实、有效、准确、完整，所提交的书面材料、副本材料或口头证言，有关材料上的签字或印章均是真实的，有关副本材料、扫描件均与正本材料一致。
（二）承诺人提交的资料任何部分均不侵犯任何第三方的知识产权或专有权利，不含任何诽谤或非法材料，不存在任何知识产权权利纠纷。
（三）自将项目资料提交至活动组委会之日起，即许可活动组委会可以将其资料在非商业用途下通过各种方式向社会展现。
二、免责声明
承诺人知悉报名提交的资料应不存在任何知识产权权利纠纷，如在活动期间或活动之后所产生的任何知识产权权利纠纷均由承诺人自行承担，与组委会无关。
As a project/technology, we obey the commitment and disclaimer to the Organizing Committee as follows:
1. Commitments
On behalf of the technology released by me, I voluntarily participate in the 2021 International Technology Trade Fair and Release on ZGC Forum “100 Best Industrial Innovations for International Technology Transfer”. (hereinafter referred to as the "Fair") and made the following commitments to the Organizing Committee：
1.1 All information provided by the declarant (including but not limited to information of the company/institution, team members, technology, presentation, etc.) is true, valid, accurate and complete. The written materials, copies or oral testimony submitted, and the signature or seal on the relevant materials are true. The relevant copies and scanned copies are consistent with the original materials.
1.2 No part of the information submitted by the declarant violates the intellectual property or proprietary rights of any third party, does not contain any defamatory or illegal material, and there is no dispute over any intellectual property rights.
1.3 From the date of submission of the technology materials to the Organizing Committee, the Committee is permitted to demonstrate the materials in public in different ways with non-commercial use.
2. Disclaimer
The declarant is aware that the information submitted for application should be free from any intellectual property rights disputes, and that any intellectual property rights disputes arising during or after the event will be the sole responsibility of the declarant instead of the Organizing Committee.
技术供给项目申请表
Technology Collection Form
注：红星标注的内容为必填项 The contents with red star is mandatory fields
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基本信息Basic Information |
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*联系人 Contact |
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*邮箱E-mail |
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*电话 Mobile No. |
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*所属机构/公司 Company/ Institution |
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*职位 Position |
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*所属公司/机构介绍 Company/Institution Introduction |
包括机构名称、成立时间、团队人数、注册资本、所在地及机构简介（300字左右）。 Including the name, founded time, number of team, registered capital, location and a brief description of the institution（about 300 words） |
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所属公司网址 Website |
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技术信息Technology Information |
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*技术名称 Technology Name |
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*所属国别 Country |
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* 技术领域 Technology Field |
□新一代信息技术 □智能制造 New Generation of ICT Intelligent Manufacturing □生物技术与创新药 □高端医疗器械 Biotechnology & Innovative Medicine High-end Medical Device □环保与可持续发展 □新能源 Environmental Protection & Sustainable Development New Energy □新材料 □现代农业 New Materials Modern Agriculture □智慧交通 □高端装备 Smart Transportation High-end Equipment
细分领域（自行填写）Fields Segmentation (fill in by yourself) |
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* 技术基本介绍 Description Of Technology
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简要介绍技术项目整体情况，含技术研发背景，应用细分领域，技术形态、应用领域，解决什么问题，技术亮点优势、发展阶段等；另外，如技术项目曾获得奖项、团队核心人物具有影响力可加分（500字左右，如有图片更佳） Briefly introduce the general situation of the technology or project, including the background of technology R&D, application segments, technology forms, application fields, what problems to solve, the advantages of technology, stages of development, etc.; In addition, it can score extra points if it has won awards, the core member of the team has influence (about 500 words, it would be better if there are pictures)
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（一）技术创新性Technological Innovation （该项在专家评审中约占50%分值Accounts for about 50% of the score in the expert's evaluation） |
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1.* 请描述该技术具备哪些技术创新性和先进性（考核该技术先进性和创新性，主要描述该技术在国内外市场类似产品或者技术对比分析、包含但不限于可公开披露的技术参数） Please describe the technological advancement and innovation (assess the technological advancement and innovation, mainly describe the comparison of similar products or technology in the domestic and international markets, including but not limited to the publicly disclosed technical parameters)
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2.* 项目所属阶段 Stage of Development □ 技术发现 Technology discovery □ 论证/验证 Demonstration/Validation □ 示范模型/专利形成 Pilot/Preclinical Stage □ 产品服务研发/工程（批量）样品/中试Product Service R&D/Engineering (Batch) Samples/Pilot testing □ 商品化/产业化阶段Commercialization/Industrialization
请描述该技术目前发展水平（主要用于评价该技术成熟度与产业化水平，主要描述该技术目前所属阶段，包括技术水平、工艺流程、配套资源、技术生命周期等产业化程度） Please describe the current development of the technology (mainly used to evaluate the maturity and industrialization level of the technology, mainly describing the current stage of the technology, including the level of technology, technological process, supporting resources, technology life cycle and others of industrialization)
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3.请说明该技术优势的可持续性和不可替代性（主要考核该技术的潜在风险，包括技术可实现风险、技术可靠性风险、 知识产权侵权风险、应用推广可行性风险、市场竞争风险、政策风险、团队风险等） Please describe the sustainability and irreplaceability of the technology advantages (mainly assess the potential risks of the technology, including technology achievability risk, technology reliability risk, intellectual property infringement risk, application feasibility risk, market competition risk, policy risk, team risk, etc.)
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（二）技术商业价值 Technology Business Value （该项在专家评审中约占40%分值 Accounts for about 40% of the score in the expert's evaluation） |
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1.*知识产权情况（主要用于评价该项目是否具有可转化的核心知识产权作为标的） Intellectual property rights (mainly used to evaluate whether the technology has the core IP rights that can be transformed as the subject) □专利Patent □集成电路设计IC Design □专有技术 Technology Know-How □商标 Trademark □计算机软件 Computer Software □工业品外观设计 Industrial Design □版权 Copyright □生产加工工艺 Manufacturing Process Technology □其它Others______________
*成果权属Ownership of IP □独占 Exclusive □共有Joint（共有权人Co-owner_______ ） □其他Others _________ *知识产权数量Number of IP ______________ 知识产权描述Description of IP：
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2.*请描述该技术潜在应用场景及目标客户（主要用于评价该技术是否有明确的目标客户、市场需求） Please describe the potential application scenarios and target customers of the technology (mainly used to evaluate whether the technology has a clear target customer, market demand) |
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3.*目标产品及描述 Target Product and Description *产品形态Product pattern： □最终消费产品Final consumer products □工业产品Industrial Products □工业中间产品Industrial intermediate products □技术服务Technical Services 其他 Others__________________
产品描述（技术是否形成产品，以及产品的设计性和创意性） Product description (whether the technology has been a product, and the designability and creativity of the product)
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4.*理想的合作方式Ideal Way of Cooperation □提供技术服务Providing technical services □提供技术咨询Provide technical consultancy services □技术联合研发 Joint R&D □技术秘密转让Transfer of technical secrets □专利权转让Transfer of patent right □专利申请权转让Assignment of patent application □专利权（专利申请技术）实施许可Patent (patent application technology) enforcement license □合作生产Joint Production □工程承包Project contracting □设备引进Introduction of Equipment □公共工程特许权（BOT）Build-operate-transfer □特许经营Franchising □补偿贸易Compensation trade □专家服务Expert service □股权投资合作Equity investment cooperation □成立独资或合资公司Establishment of Sole Proprietorship or Joint Venture □创新技术产品市场开拓Market development of innovation technology products □合同研发外包R&D outsourcing contract □创新技术供应链合作Innovation technology supply chain cooperation □其他Others___________
请详细阐述理想的合作方式（包括理想的合作机构<合作机构属性、所属领域、行业地位等>，合作业务，合作目标等） Please describe the ideal cooperation ways in details (including the ideal cooperation organization <properties, field, industry status and others>, cooperation business, cooperation targets, etc.)
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5.* 是否考虑在中国成立公司或分支机构Will to set up a company or branch in China □ 是 Yes □ 否 No |
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6. 目前该技术融资情况及融资需求（用于评价该技术目前市场价值） Current investment and financing needs (for evaluating the current market value of the technology) |
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团队核心专家Core Experts |
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*姓名Name |
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*职位 Position |
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PHOTO 200*200PX |
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*国籍 Nationality |
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*最高学位 Highest Degree |
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出生年月 Date of Birth |
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毕业院校及专业 Graduate Institution & Major |
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联系方式 Contact |
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*专业领域 Professional Field |
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*个人简介：包括团队职能、工作经历和业绩、行业技术地位（水平）等。 Profile: including roles of the team, work experiences and performance, technical status (level) in the industry, etc. |
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可添加补充其他成员介绍 Introduction of Other Members
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*填写完毕后，请将该文件与如有可对外公开的BP/技术或机构宣传视频/路演ppt，请一并发送至storyw@163.com；
