Non-Disclosure Agreement (NDA) Routing Form
GT’s Point of Contact Information:
Name & Title: Department:
Email: Phone: Mail Code:
Selec
t one of the following:
Provide the class name and number | description of the academic collaboration | description of the purchase:
Co
mpany’s Information:
Company Name:
Address:
Name of Technical Contact:
Phone: Email:
Name of Contracts Contact
1
:
Phone: Email:
Wi
ll you be disclosing and/or receiving proprietary information?
2
Non-confidential description of the subject matter or project name
3
:
Are you going to disclose and/or receive export controlled information?
Ar
e there any foreign nationals working on this project?
If yes, from which countries:
Estimated date when you expect the exchange of proprietary information will begin:
Estimated timeframe when you expect the exchange of information will cease:
Estimated length of time the proprietary information should be protected (in years)
4
:
I HAVE COMPLETED THIS FORM TO THE BEST OF MY KNOWLEDGE AND HAVE READ THE RELATED NON-DISCLOSURE AGREEMENT, AND I WILL
INDICATE TO THE ATTORNEY PROCESSING THIS AGREEMENT ANY OBJECTIONS I MAY HAVE TO THE PROVISIONS OF THE AGREEMENT
.
Signature of GT POC: Date:
1
The company’s contracts contact is the person who is authorized to negotiate and approve changes to the NDA on the company’s behalf.
2
If proprietary information is not going to be exchanged, there is no need for an NDA.
3
This form and the resulting NDA are not proprietary as they are subject to disclosure under the Open Records Act.
4
The period of confidentiality is normally five (5) years – the period covered in your employment agreement with Georgia Tech. A term
longer than five (5) years requires the approval of your School Chair or your Center/Lab Director and the execution of an internal
agreement in which you agree to keep the information confidential for the extended term.
Please submit the fully completed and signed form to asklegal@gatech.edu for review and assignment. Failure to provide
any of the information requested on this form may cause a delay in processing your NDA. For questions call 404.894.4812.
Updated July 2019
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