SBA Form 2214 Scor Initial Economic Impact Study Survey Score

U.S. Small Business Administration

Office of Entrepreneurial Development

Initial Economic Impact Survey

OMB Number 3245-0351

Expiration 06/30/2012

Dear Small Business Client:

Thank you for your recent visit to SCORE, one of SBA’s Entrepreneurial Development (ED) Resource Partners. We hope you found the business assistance you sought. The SBA is always striving to better its programs and deliver relevant and meaningful assistance. We want to know if our programs and services are helping the economy by providing useful information on starting and managing a business and eventually helping your business create jobs, increasing your business’ revenues and, in general, fueling the entrepreneurial spirit in America.

You have been selected to assist the SBA by completing a brief online questionnaire by clicking on the following URL: http://www.surveytracker.com/survey/scoresurvey

After completing this online survey, you will receive a confirmation page indicating your survey was accepted. Data will automatically be entered into the Economic Impact Survey database. All data will be held in strict confidence and reported only in the aggregate without identifying and individual small business. If you have trouble accessing the survey, please contact Matthew Herman at mherman@concentrance.com or 202.223.8877.  The data will not be released to any other government agency or private firm. Based on your visit to SCORE, please use that experience as a benchmark to answer the following:

1. Are you currently in business? Yes □ No □

If YES when was the business started? _ _/_ _ _ _

mm/ yyyy

What is the zip code of your business location ­__ __ __ __ __

If Yes skip to question

1a. If NO, when do you plan on starting a business?

Within 30 days □ 31-90 days □

91-120 days □ No idea at this time □

1b If NO (to question 1), have you ever been in business?

Yes □ No □

If YES when was the business started? _ _ /_ _ _ _

mm/yyyy

1c. If you were not in business at the time you were assisted by the counselor, did you decide to go into business as a result of that assistance?

Yes □ No □

If you answered NO to question 1, please skip to Question 14

2. As a result of the assistance you received, have you changed any of your current management practices/strategies? Yes □ No □

3. As a result of the assistance I received from the [SBDC/WBC/SCORE] Counselor, I was able to develop (i.e., Business Plan] in order to better manage my business. [Check all that apply]

Business Plan □ Loan Package □ Purchasing Strategy □

Marketing Plan □ Hiring Plan □ Feasibility Plan □

Promotional Plan □ Training Plan for Staff □ Production Plan □

Pricing Strategy □ Financial Strategy □ Distribution Plan □

Cash Flow Analysis□ Web Based Strategy □ International Trade □

General Management □ Other ________________________

4. Please indicate the impact these changes have had on your firm:

[Strongly Agree=SA, Agree=A, No Opinion=NO, Disagree=D, Strongly Disagree=SD]

SA A NO D SD

I was able to:

1. Increase my sales 5 4 3 2 1

2. Improve my cash flow 5 4 3 2 1

3. Acquire an bank loan 5 4 3 2 1

4. Expand my products/services 5 4 3 2 1

5. Hire new staff 5 4 3 2 1

6. Revise my marketing strategy 5 4 3 2 1

7. Increase my profit margin 5 4 3 2 1

8. Retain current 5 4 3 2 1

9. Acquire a SBA guarantee loan 5 4 3 2 1

10. Acquire a government contract 5 4 3 2 1

11. Acquire an SBA Disaster loan 5 4 3 2 1

12. Other (specify _____________) 5 4 3 2 1

5. Please indicate how useful the services were that you received from the counselor who assisted you in identifying and correcting problems in operating your business.

Very No Somewhat Not

Useful Useful Opinion Useful Useful

1. Counseling was Relevant 5 4 3 2 1

2. Counseling was Timely 5 4 3 2 1

3. Counseling was Helpful 5 4 3 2 1

4.

6. At the time you were assisted by the Small Business Development Center (SBDC), what was the approximate annual gross revenue for each of the calendar years below:

2007: __________________________

2008: __________________________

7. Counting yourself, how many people full-time employees (35 hours or more per

week) and part-time employees (less than 35 hours per week), did you have at the end of the following years you were in business? If you were not in business, just write N/A in the appropriate blank.

2007 _______________ Number of Full-time employees

2008 _______________ Number of Full-time employees

2007 _______________ Number of Part-time employees

2008 _______________ Number of Part-time employees

8. If you were projecting to reduce your total number of employees prior to counseling, by the SBDC how many positions do you/have you retained due to the counseling?

Existing Full-time jobs saved ___________

Existing part-time jobs saved ___________

9. If you are in business, what is the primary type of business? [Please choose only one]

Construction □ Manufacturing □ Consulting □

Wholesale □ Finance, Insurance and Real Estate □ Entertainment □

Retail □ Restaurant and/or Eating and Drinking □ Engineering □

Publishing □ Education □ Service □

Health Care □ Day Care □ Transportation □ Technology □

Health, Wellness and/or Fitness Other (describe) _______________________

10. Indicate the geographic location of your primary business.

Rural _________ Urban _________ Inner City _________________

11. What lead to your decision to seek business counseling from ____ (check all that apply)

Tried other alternatives and was dissatisfied ___________

Reputation of SBDC __

Referred by __ fill in blank or add options such as SBA office__

Low/free cost of service ____________________________

12. Please indicate the value of the information you received from the counselor you visited:

Extremely No Somewhat Not

Valuable Valuable Opinion Valuable Valuable

1. Information was useful 5 4 3 2 1

2. Information was relevant 5 4 3 2 1

3. Information was timely 5 4 3 2 1

13. Please indicate the counselor effectiveness in assisting you:

[Strongly Agree=SA, Agree=A, No Opinion=NO, Disagree=D, Strongly Disagree=SD]

SA A NO  D SD

1. The counselor exhibited excellent

customer service techniques 5 4 3 2 1

2. The counselor was ability to assist me 5 4 3 2 1

3. The counselor exhibited a high level of

professionalism 5 4 3 2 1

4. The counselor was knowledgeable of current

management practices and issues 5 4 3 2 1

5. The counselor identified with my needs 5 4 3 2 1

6. I would rate my overall experience with

the counselor as excellent 5 4 3 2 1

14. I would refer the counseling services I received to other small businesses.

Strongly Agree □ Agree □ No Opinion □ Disagree □ Strongly Disagree□

15. Gender: Male □ Female □

16. Veterans status: Veteran □ Service Disabled Veteran □

Reservist □ National Guard member □ Non Veteran □

17. Age: [Circle one] 18-24 25-34 35-44 45-54 55-64 65-74 75+

18. Are you: Hispanic or Latino □ Not of Hispanic/Latino Origin □

19. Are you: [Please choose one or more]

American Indian or Alaskan Native □ Asian □

Black or African American □ Native Hawaiian or Pacific Islander □

White □

20. Did you utilize any other SBA resources/program?

Yes □ No □

If YES, select those you used [Check all that apply]

SCORE □ SBA’s guarantee loan programs □

Women Business Center □ SBIC Venture Capita; Program □

Government Contracting □ SBA’s Surety Bond Program □

Small Business Training Network □ Disaster Assistance □

(On-line training)

PLEASE NOTE: The estimated burden for completing this form is 12 minutes per response. You are not required to respond to any collection of information unless it displays a currently valid OMB approval number. Comments on the burden should be sent to U.S. Small Business Administration, Chief, AIB, 409 3^rd St., S.W., Washington, D.C. 20416 and Desk Officer for the Small Business Administration, Office of Management and Budget, New Executive Building, Room 10202, Washington, D.C. 20503. OMB Approval (3245-0351). PLEASE DO NOT SEND FORMS TO OMB.

SBA Form 2214 THANK YOU