Omnibus NSF Engineering Longitudinal Survey Instrument Time 2

Appendix A: Omnibus NSF Engineering Longitudinal Survey
Instrument Time 2

2

The omnibus instrument below shows all the questions across the survey groups of this ICR. It
shows common questions for the I-Corps and non-I-Corps participants, as well as questions that
are unique to each of these two respondent groups. The second column shows which respondent
group(s) the question applies to. To facilitate review, we show only questions for I-Corps
respondents in Appendix B. Finally, Appendix C shows only questions for non-I-Corps PI
respondents.
Omnibus Survey of Entrepreneurial Outcomes (I-Corps grantee and non-I-Corps PI respondents)
Item
#

Respondent
Group

NSF Award Commercialization History (Survey Screener)

1

Non-ICorps
Only

Have you ever received an I-Corps Team award from the National Science Foundation (NSF)?

Non-ICorps
Only

Have you ever received an I-Corps at NIH award from the National Institutes of Health (NIH)?

2

3

Non-ICorps
Only

•
•

Yes [Exit Survey]
No

•
Yes [Exit Survey]
•
No
Our records indicate that you received the following awards from NSF between 2009 and 2013.
For each project listed below, please indicate whether you have made any effort to explore the
commercialization of your NSF research.
Examples of steps that might be taken to commercialize your NSF research include:
•
•
•
•
•

Conducting outreach to prospective customers;
Receiving entrepreneurial training/education;
Seeking funding to promote research translation;
Contributing to R&D to bring product/technology to market; and
Seeking support from technology transfer or entrepreneurial office.

Project Name

1. Project Title A
2. Project Title B
3. Project Title C
4. Project Title D

Award Number
Award Number
A
Award Number
B
Award Number
C
Award Number
D

Start and end
dates

Have you taken any
steps to commercialize
this project (select one
for each project)
Yes
No

Start and End
Dates
Start and End
Dates
Start and End
Dates
Start and End
Dates

5. Other (please specify)
(IF ALL PROJECTS LISTED ABOVE ARE MARKED NO THE RESPONDENT WOULD GO TO THE
DEMOGRAPHICS SECTION)
IF ONLY ONE PROJECT IS MARKED YES, THE RESPONDENT WOULD PROCEED TO Q4

3

3.a.

Non-ICorps
Only

IF MORE THAN ONE PROJECT IS MARKED YES, THE RESPONDENT WOULD BE ASKED THE FOLLOWING:
You have indicated that you made efforts to explore commercialization on more than one NSF project
since 2009. Select the one project that you think has advanced the most in terms of
commercialization. For the remainder of the survey, we will refer to this project as “your NSF project.”
[LIST OF PROJECTS SELECTED YES IN ITEM 3]
Your Commercialization Effort

4

Non-ICorps
Only

What activities did you undertake when you explored commercialization related to your NSF project?
(Select all that apply)
•
Led efforts to conduct outreach with prospective customers
•
Participated in entrepreneurial training
•
Applied for grants to promote commercialization
•
Contributed to R&D of product/technology to get it to market
•
Sought support from university entrepreneurial office
•
Sought support from university technology transfer office
•
Other (Please specify)

5

Non-ICorps
Only

What was the first year in which you undertook any of the above commercialization activities? For
the rest of this survey, we will consider this to be the year in which year you started the effort to
commercialize your NSF project.
[YYYY]

6

Non-ICorps
Only

Did you develop a formal written s strategy to guide your efforts to commercialize research related to
your NSF project?
•
Yes
•
No

7

Non-ICorps
Only

Enter the approximate number of times you have participated in each of the following
experiences/activities prior to the start of the commercialization of your NSF project. Enter zero (0) if
you never participated in that experience/activity:
Contributed ideas utilized by a company to improve a product, service,
or process
Presented a business idea to investors
Generated trade secrets
Served on a corporate advisory board
Founded or cofounded a venture (for-profit, nonprofit, not-for-profit)
that developed or sold products or services based on your research
Participated in the technology transfer process at your university
Disclosed an invention to the university
Licensed your research/technology
Received royalties for your work
Participated in industry funded research
Issued a patent
Interviewed potential customers about a product, service, or technology
Conducted market research
Applied for a patent as an inventor or co-inventor

4

8

Non-ICorps
Only

9

Non-ICorps
Only

10

Non-ICorps
Only

For each of the following types of entrepreneurial training, indicate the length of time, if any, you
received training.
Total cumulative time for all occurrences?
I-Corps-sponsored Courses (offered at
•
Never
I-Corps Site or Node programs but not
•
Less than 1 day
associated with an I-Corps Team’s
•
At least 1 day but less than 1 week
award)
•
At least 1 week but less than1 month
•
At least 1 month but less than 1 semester
•
At least 1 semester but less than 1 year
•
1 year or more
Courses using Customer Discovery or
•
Never
the Business Model Canvas
•
Less than 1 day
•
At least 1 day but less than 1 week
•
At least 1 week but less than1 month
•
At least 1 month but less than 1 semester
•
At least 1 semester but less than 1 year
•
1 year or more
Accelerator Programs (e.g. Tech Stars
•
Never
or Y Combinator)
•
Less than 1 day
•
At least 1 day but less than 1 week
•
At least 1 week but less than1 month
•
At least 1 month but less than 1 semester
•
At least 1 semester but less than 1 year
•
1 year or more
Other entrepreneurial educational
•
Never
programs. Please specify.
•
Less than 1 day
•
At least 1 day but less than 1 week
•
At least 1 week but less than1 month
•
At least 1 month but less than 1 semester
•
At least 1 semester but less than 1 year
•
1 year or more
What other types of commercialization support, excluding training, have you received?
Please choose all that apply:
•
One-on-one coaching
•
Group coaching
•
Peer support
•
University based mentor
•
Industry based mentor
•
Other (Please specify)
•
None
Are you familiar with the Osterwalder Business Canvas Model?
•
Yes
•
No
Project Status

11

I-Corps
only

Since you last updated us in 2014, have you been involved with the I-Corps project?
If you continued involvement, please describe how you were involved in the comment box.
•
Yes, I continued to be involved with the project
•
No, I stopped being involved with the project.
Make a comment on your choice here:

5

12

I-Corps
only

12.1

NSF ICorps
Mentors
Only

12.2

NSF ICorps
Mentors
Only

13

All

14

Non-ICorps
Only
Non-ICorps
Only

15

16

All

17

All

[If item 11 (involvement with I-Corps project) response is "No, I stopped being involved with the
project."]
If you know who is the most knowledgeable person to contact about the project right now, please
provide details below.
Name:____________
Role in project:____________
[If item 11 (involvement with I-Corps project) response is “Yes, I continued to be involved with the
project”] Please indicate what type of involvement, if any, you still have with the above I-Corps team.
•
I am no longer involved at all.
•
I still act as mentor (including casual phone calls, emails, etc.)
•
I am an advisor sharing specific expertise (e.g., legal advice) with the team or company
•
I am an investor or shareholder in the related company
•
I serve on the board of directors of the related company
•
I am on the management team of the related company (e.g., CEO or CFO)
[If item 11 (involvement with I-Corps project) response is “Yes, I continued to be involved with the
project” and Item 12.1 (level of mentor involvement) is anything except for “I am no longer involved at
all”] In your current role, can you provide specific details about the team's project status (e.g., when a
company was formed or whether there are any product sales)?
•
Yes
•
No
Is this [commercialization effort/project] still active?
•
Yes [go to item 15]
•
No
•
Uncertain [go to item 16]
[If “No” to item 13]
In what year would you say that your efforts to commercialize the NSF project research stopped?
YYYY [go to item 12]
[If “Yes” to item 13]
How involved are you in the commercialization effort?
•
Very involved
•
Involved
•
Somewhat involved
•
Not involved at all
[If item 11 (whether project is active) response is "Uncertain"]
Select any of the reasons listed below that explain why you are uncertain.
•
We have not yet identified a large enough market for our product/technology
•
The time to get the technology into market may be too great
•
We are encountering difficulties with our technology itself
•
We have not yet obtained needed financing/investment to continue
•
We are having problems with intellectual property
•
We are having problems with our team
•
Other (specify)
[If item 13 (whether project is active) response is "No"]
Why is this project no longer active?
•
We successfully commercialized our project
•
We decided to discontinue pursuing commercialization for our project
•
Other (Specify)

6

17.1

All

18

All

18.1

All

[If item 14 (reasons project is not active) response is "We decided to discontinue commercialization for
our project"]
Did you decide to discontinue pursuing commercialization for your project for any of the following
reasons? [check all that apply]
•
We were not able to identify a large enough market for our product/technology
•
The time to get the technology into market was too great
•
We had problems with our intellectual property
•
We encountered difficulties with the technology or product
•
We could not obtain necessary financing/ investment to continue
•
The company was acquired
•
We had problems with our team
Which of the following best describes your NSF project's main area of research or technology?
•
Advanced Manufacturing and Nanotechnology (MN)
•
Advanced Materials and Instrumentation (MI)
•
Biological Technologies (BT)
•
Biomedical Technologies (BM)
•
Chemical and Environmental Technologies (CT)
•
Educational Technologies and Applications (EA)
•
Electronic Hardware, Robotics and Wireless Technologies (EW)
•
Internet of Things (I)
•
Information Technologies (IT)
•
Semiconductors (S) and Photonic (PH) Devices and Materials
•
Smart Health (SH)
•
Other Topics (OT) – please describe: _________
[If item 18 (tech clusters) response is "Smart Heath (SH) and Biomedical Technologies (BM)"]
Please specify:
• Electronic health/education tools
• Life sciences research tools
• Medical devices (including medical imaging devices and innovative materials to construct new
devices)
• Medical diagnostics
• Therapeutics (including small molecules, biologics, and imaging agents)
• Other
Your Team

19

19.a

Non-ICorps
Only

Non-ICorps
Only

In this section, we will obtain information about any individuals whom you worked closely with in your
efforts to commercialize your NSF project. By this we mean those who supported your efforts in a
direct capacity (e.g., individuals who were brought on to help you navigate any difficulties you might
experience in advancing your commercialization efforts). We will refer to these individuals as members
of your team. Do not count external firms that you have hired to provide advice or other services.
Since you began exploring the commercial opportunities associated with your NSF project, have you
worked closely individuals who supported your effort in direct capacity?
•
Yes
•
No [go to item 23]
Since you began exploring the commercial opportunities associated with your NSF project, how many
team members have you worked closely with?
[type number]

7

20

Non-ICorps
Only

When the team collaboration began, were any of the members of your team:
[check all that apply]
•
A post-doctoral or graduate student
•
A fellow faculty/researcher
•
Someone outside of academia
•
Someone associated with a technology transfer/entrepreneurial office

21

Non-ICorps
Only
Non-ICorps
Only

Did any of these team members have prior entrepreneurial background?
•
Yes
•
No
What activities did the team members undertake when working on the commercialization effort of
your NSF project? (Check all that apply)
•
Led efforts to conduct outreach with prospective customers
•
Provided advice based on prior entrepreneurial background
•
Contributed to R&D of product/technology
•
Sought support from university entrepreneurial or technology transfer office
•
Represented or acted as a potential investor
•
Other (specify)

22

Business Creation or Dissolution
23

All

24

I-Corps
only

[If no company in VW database (via intake/post responses, news forwarded from NSF project officer,
etc.)]
Our records indicate that no company has been incorporated based on your I-Corps project. Is this still
correct?
•
No company has been incorporated
•
One or more companies have been incorporated
________________________________
[For non-I-Corps]
Has a company been incorporated based on your NSF project?
•
Yes [go to item 23]
•
No [go to item 25]
We have the following company information associated with your team.
Company Name: [COMPANY NAME FROM VW DATABASE]
Incorporation date: [COMPANY INCORPORATION DATE FROM VW DATABASE]
Current status: [ACQUIRED OR ACTIVE - Time 1 and VW COMPANY DATABASE]
Website: [COMPANY WEBSITE FROM VW DATABASE]
If any information needs to be updated, please Multiple choice.

25

Non-ICorps
Only

26

All

If existing company in VW database (via intake/post responses, news forwarded from NSF project
officer, etc.)
•
Name is incorrect
•
Incorporation date is incorrect or needs to be added
•
Website is incorrect or needs to be added
[If no in item 23]
Did you previously incorporate a company that you used to or could use to commercialize your NSF
project research?
•
Yes
•
No [go to 38]
[if yes to 23 or 25] What is the name of this company? If you are unsure, please type "unsure."
Please note that if there are multiple companies, we ask that you respond only for the company that
was active most recently.
Text: open

8

27

All

[if yes to item 23 or 25] What is the URL of the company's website, if any?

28

All

[if yes to item 23 or 25] When was the company incorporated? (mm/dd/yyyy)

29

All

30

All

31

All

32

All

33

I-Corps
only

34

I-Corps
only

[if yes to item 23 or 25] Is this company still operational?
•
Yes
•
No
[if yes to item 23 or 25] What sector best describes this company?
•
Agriculture
•
Education
•
Energy & Materials
•
Environment
•
Healthcare/Medical
•
Information Technology and Communication
•
Infrastructure/Building
•
Sanitation/Water
•
Other (specify)
[If response to item 29 (whether company is operational) is "No"]
Why did the company close/dissolve?
[Check all that apply]
•
We were not able to identify a large enough market for our product/technology
•
The time to get the technology into market was too great
•
We had problems with our intellectual property
•
We encountered difficulties with the technology or product
•
We could not obtain necessary financing/investment to continue
•
The company was acquired
•
Other (specify)
[If response to item 29 (whether company is operational) is "No"]
Approximately when did this company close or dissolve?
(mm/yyyy)
[If response to item 23 (new company creation) is "one or more companies have been incorporated"
OR If response to item 24 (whether Time 1 response needs to be updated) is "Yes"]
Which of the following best describes how the business was started.
•
A new business, branch or subsidiary owned by an existing business
•
A business inherited from someone else
•
A new, Independent business created by a single person or a team of people
•
The purchase of an existing business
•
The purchase of a franchise
•
An organization designed for social and charitable objectives and legally established as a notfor-profit
•
Other (specify)
[If existing company in VW database (via intake/post responses, news forwarded from NSF project
officer, etc.) AND Time 1 response to this question.]
In 2014, you told us that:
The business was started as [STARTING BUSINESS FORM AT Time 1].
The business's current legal form is a(n) [CURRENT BUSINESS FORM AT Time 1].
If it had another legal form, the business was previously a(n) [OTHER LEGAL FORM AT Time 1].
Is this still correct? *
•
Yes
•
No

9

35

I-Corps
only

36

I-Corps
only

37

I-Corps
only

[If response to item 23 (new company creation) is "one or more companies have been
incorporated"OR If response to item 24 (whether Time 1 company info is correct) is "No"]
Which form of legal status does the business currently have?
•
Sole Proprietorship: A type of business ownership in which a business is owned and managed
by one individual and no sub-chapter S-corporation or C-corporation has been established.
•
Limited Liability Company: A cross between a corporation and a partnership, and offering
some of the benefits of both. Similar to S corporations, income produced by a limited
liability company flows through the owners (known as “members”) who pay their own taxes
as individuals. Unlike S corporations, however, limited liability companies are not subject to
as many government restrictions.
•
Sub-chapter S-Corporation: Corporations in which all profits and losses are passed through
to shareholders, just as they are passed through to legal partners in a partnership.
•
C-Corporation: Legal entities separate from their owners that may engage in business, make
contracts, own property, pay taxes, and sue and be sued by others.
•
General Partnership: An association of two or more people who co-own a business for the
purpose of making a profit and no sub-chapter S-corporation or C-Corporation has been
established.
•
Limited Partnership: A partnership in which one or more partners who manage the business
and others are limited partners who invest in the business but forgo any right to manage the
company.
•
Other (specify)
[If response to item 23 (new company creation) is "one or more companies have been incorporated"
OR If response to item 24 (whether Time 1 company info is correct) is "No"]
Since you incorporated, were the business operations ever conducted under one of the other legal
forms listed above?
•
Yes
•
No
[If response to item 23 (new company creation) is "one or more companies have been
incorporated"ORIf response to item 24 (whether Time 1 company info is correct) is "No"]
Which form of legal status did the business previously have?
•
Sole Proprietorship: A type of business ownership in which a business is owned and managed
by one individual and no sub-chapter S-corporation or C-corporation has been established.
•
Limited Liability Company: A cross between a corporation and a partnership, and offering
some of the benefits of both. Similar to S corporations, income produced by a limited
liability company flows through the owners (known as “members”) who pay their own taxes
as individuals. Unlike S corporations, however, limited liability companies are not subject to
as many government restrictions.
•
Sub-chapter S-Corporation: Corporations in which all profits and losses are passed through
to shareholders, just as they are passed through to legal partners in a partnership.
•
C-Corporation: Legal entities separate from their owners that may engage in business, make
contracts, own property, pay taxes, and sue and be sued by others.
•
General Partnership: An association of two or more people who co-own a business for the
purpose of making a profit and no sub-chapter S-corporation or C-Corporation has been
established.
•
Limited Partnership: A partnership in which one or more partners who manage the business
and others are limited partners who invest in the business but forgo any right to manage the
company.
•
Other (specify)

10

37.1

I-Corps @
NIH only

[Item 13 (whether project is active) response is "Yes"]
Please select the items below that are true of your business.

Women are …
Socially disadvantaged individuals are …

37.2

I-Corps @
NIH only

38

I-Corps
only

majority
owner(s)
□
□

co-owner(s)
□
□

in leadership
role(s)
□
□

Help text: The SBA defines socially disadvantaged individuals as "those who have been subjected to
racial or ethnic prejudice or cultural bias because of their identity as a member of a group without
regard to their individual qualities."
["If response to item 13 (whether company is active) is "yes"]
Does your business meet the requirements for 8(a) certification?
•
Yes, and we are 8(a) certified
•
Yes, and our 8(a) application is in process
•
Yes, and we intend to apply for 8(a) certification
•
Yes, and we do not intend to apply for 8(a) certification
•
No, we do not meet the requirements
•
Unsure
Business Information

39

40

All

I-Corps
Only

[If existing company in VW database (via intake/post responses, news forwarded from NSF project
officer, etc.) AND Time 1 responses to this group of questions. If more than one company, showing
active one only]
We have the following CEO information for [COMPANY NAME FROM VW DATABASE]:
Role on I-Corps team: [Time 1 RESPONSE]
Industry type, if not from I-Corps team: [Time 1 RESPONSE]
Is this still correct?
•
Yes
•
No
[If response to item 23 (new company creation) is "one or more companies have been incorporated"
OR “no” for non-I-Corps OR If response to item 38 (whether Time 1 CEO info is correct) is "No"]
Who is the CEO of your company? If you would like to explain your answer further, please use the
comment box.
•
The I-Corps PI
•
The I-Corps EL
•
The I-Corps Mentor
•
Other (specify)
________________________________
[For non-I-Corps]
What is your role in the company?
[Check all that apply]
•
I am the Chief Executive Officer (CEO) or equivalent
•
I am the Chief Technology Officer (CTO) or equivalent
•
I am the Chief Operations Officer (COO) or equivalent
•
I am a lead researcher at the company.
•
I am not an officer in the company but serve in other capacity.
•
I am not involved with the company.
[If response to item 38 (CEO of company) was "Other"]
Please indicate what industry or type of business the CEO is from.
Text box

11

41

I-Corps
Only

42

I-Corps
Only

43

I-Corps
Only

46

I-Corps
only

47

I-Corps
only

[If response to item 23 (new company creation) is "one or more companies have been incorporated"
OR If existing company in VW database (via intake/post responses, news forwarded from NSF project
officer, etc.)]
Which companies do you consider to be your major competitors and why?
Text box
["If response to item 23 (new company creation) is "one or more companies have been incorporated"
OR If existing company in VW database (via intake/post responses, news forwarded from NSF project
officer, etc.)]
What sector best describes the industry of your major competitors?
•
Agriculture
•
Education
•
Energy & Materials
•
Environment
•
Healthcare/Medical
•
Information Technology and Communication
•
Infrastructure/Building
•
Sanitation/Water
•
Other (specify)
[If response to item 23 (new company creation) is "one or more companies have been incorporated"
OR If existing company in VW database (via intake/post responses, news forwarded from NSF project
officer, etc.)]
Which company size best describes your major competitors?
•
1-10 employees
•
11-50 employees
•
51-200 employees
•
201-500 employees
•
501-1000 employees
•
More than 1000 employees
•
Other (specify)
If response to item 23 (new company creation) is "one or more companies have been incorporated"
OR If existing company in VW database (via intake/post responses, news forwarded from NSF project
officer, etc.)]
Who is the majority or principal shareholder of the company?
•
The I-Corps PI
•
The I-Corps EL The I-Corps EL
•
The I-Corps mentor The I-Corps mentor
•
Equal shareholders (please describe)
•
Other (specify)
[If existing company in VW database (via intake/post responses, news forwarded from NSF project
officer, etc.) AND Time 1 responses to this set of items]
In 2014, you told us that [COMPANY NAME FROM VW DATABASE] had the following:
[Time 1 RESPONSE] Individuals or entities who owned shares in the business
[Time 1 RESPONSE] owner(s) who actively helped run the business
[Time 1 RESPONSE] full time employees
[Time 1 RESPONSE] part time employees

48

I-Corps
only

Is this information still correct?
•
Yes
•
No
[If response to item 23 (new company creation) is "one or more companies have been incorporated"
OR If response to item 47 (whether Time 1 ownership and employees responses are still correct) is
"No"]
Since participation in I-Corps, how many individuals or entities owned shares in the business?
Text box

12

49

I-Corps
only

50

All

50.1

I-Corps
only

50.2

I-Corps
only

[If response to item 23 (new company creation) is "one or more companies have been
incorporated"ORIf response to item 47 (whether Time 1 ownership and employees responses are still
correct) is "No"]
Of the owner or owners since participation in I-Corps, how many owners actively helped to run the
business?
Text box
[By” helped to run the business” we mean that they provided regular assistance or advice with day-today operations of the business, rather than providing only money or occasional operating assistance.]
["If response to item 29 (whether company is active) is "yes"]
Not counting owner(s), approximately how many people currently work for the business?
•
Full time employees***
•
Part time employees
*** Full time: working 35 hours or more per week.
["If response to item 29 (whether company is active) is "yes"] Do you or your employees draw a salary
from your business?
•
Yes
•
No
[If response to item 50.1 (whether anyone draws a salary) is “yes”] Please estimate the average salary
of all employees of your business. Include yourself or any other owners in your estimate.
Textbox
For example, if there are 3 employees, and their individual salaries are $10,000, $20,000 and $30,000,
the average salary of all employees is $20,000.
Engaged in Licensing

51

I-Corps
Only

[If item 11 (involvement with I-Corps project) response is "yes, I continued to be involved with the
project" AND If response to item 47 (whether Time 1 ownership and employees responses are still
correct) is "No"]
After the I-Corps course ended, did you engage in any licensing activities?
•
Yes
•
No
Licensing Activities

52

53

I-Corps
Only

[If Time 1 response] In 2014, you told us that [XXX] employee(s) worked in areas related to product
development or other activities arising from your I-Corps participation.

I-Corps
Only

Is that still correct?
•
Yes
•
No
[If response to item 51 (licensing activities) is "Yes" OR If response to item 52 (whether Time 1
employees in product development is still correct) is "No"]
How many employees work in areas related to product development or other activity arising from
your I-Corps participation?

13

54

I-Corps
Only

55

All

56

I-Corps
Only

[If Time 1 response]
In 2014, you told us that your business had:
[Time 1 response] invention(s) disclosed
[Time 1 response] patent application(s)
[Time 1 response] patent(s) granted
[Time 1 response] patent(s) in use
[Time 1 response] invention(s) producing royalties
[Time 1 response] software copyright(s)
[Time 1 response] company trademark(s)
[Time 1 response]} non-disclosure agreement(s) (NDA)
[Time 1 response] materials transfer agreement(s) (MTA)
Are these totals still correct?
•
Yes
•
No
How many of the following does the business have? Enter "0" if none.
•
Inventions Disclosed ________
•
Licensing Agreements ________
•
Patent Applications ________
•
Patents Granted ________
•
Patents in Use ________
•
Inventions Producing Royalties ________
•
Software Copyrights ________
•
Company Trademarks ________
•
Non-disclosure Agreements (NDA) ________
•
Materials Transfer Agreements (MTA) ________
[If Time 1 response]
In 2014, you told us that your business had the following licensed out** since participating in I-Corps:
[Time 1 response] patents
[Time 1 response] copyrights
[Time 1 response] trademarks
Are these totals still correct?

57

I-Corps
Only

*** Licensing out is licensing patents, copyrights, or trademarks owned by the business to other
parties under a licensing agreement.
•
Yes
•
No
[If response to item 51 (licensing activities) is "Yes" OR If response to item 56 (if Time 1 licensing
correct) is "No"]
In 2014, you told us that your business had the following licensed in** since participating in I-Corps:
{TOKEN:ATTRIBUTE_42} patents
{TOKEN:ATTRIBUTE_32} copyrights
{TOKEN:ATTRIBUTE_33} trademarks
Are these totals still correct?
•
Yes
•
No
**Licensing in is acquiring the right to use intellectual property such as patents, copyrights, or
trademarks created by someone outside the business through a licensing agreement.

14

58

All

[Since you started the commercialization efforts related to your NSF project}, how many of the
following has the business licensed out?*** Enter "0" if none.
Licensed OUT**
Patents
Copyrights
Trademarks
Trade Secrets
** Licensing out is licensing patents, copyrights, or trademarks owned by the business to other parties
under a licensing agreement.

58.1.

All

[Since you started the commercialization efforts related to your NSF project}, how many of the
following has the business licensed in?*** Enter "0" if none.
Licensed IN**
Patents
Copyrights
Trademarks
Trade Secrets
*** Licensing in is acquiring the right to use intellectual property such as patents, copyrights, or
trademarks created by someone outside the business through a licensing agreement.
Sought Funding

59

All

Did you seek funding for your NSF project from any of the following sources? Please check all that
apply?
•
Federal government funding
•
State or regional government funding
•
Non-government funding
•
I did not seek funding
Federal Funding

60

All

[If “Federal government funding” is selected in item 59 (types of funding sought)]
Did you apply for government funding from any of the following agencies? (Check all that apply)

National Science Foundation
Department of Agriculture
Department of Commerce
Department of Defense
Department of Education
Department of Energy
Department of Health and Human Services
Department of Homeland Security
Department of Transportation
Environmental Protection Agency
National Aeronautics and Space Administration
National Institute of Standards and Technology
National Oceanic and Atmospheric Administration

Yes
□
□
□
□
□
□
□
□
□
□
□
□
□

No
□
□
□
□
□
□
□
□
□
□
□
□
□

15

61

All

[If “Federal government funding” is selected in item 59 (types of funding sought)]
Did you receive government funding from any of the following agencies? (Check all that apply)
Yes
□
□
□
□
□
□
□
□
□
□
□
□
□

National Science Foundation
Department of Agriculture
Department of Commerce
Department of Defense
Department of Education
Department of Energy
Department of Health and Human Services
Department of Homeland Security
Department of Transportation
Environmental Protection Agency
National Aeronautics and Space Administration
National Institute of Standards and Technology
National Oceanic and Atmospheric Administration

No
□
□
□
□
□
□
□
□
□
□
□
□
□

State and Regional Funding
62

All

[If "State or regional government funding" is selected in item 59 (types of funding sought)]
Please enter as much information as you can about any additional state or regional government
funding you received for your I-Corps project below.
Date
awarded
(mm/yyyy)

Amount
awarded

State
Abbreviation,
if applicable
(MA, NY etc.)

Region, if
applicable

Description

Additional Government Funding 1
Additional Government Funding 2
Additional Government Funding 3
Additional Government Funding 4
Additional Government Funding 5
Additional Government Funding 6

63

All

[If "State or regional government funding" is selected in item 59 (types of funding sought)]
Have you received any additional government funding not covered under federal funding or
state/regional funding above?
•
Yes
•
No
Please explain:
Private Funding

64

All

[If "Non-government funding" is selected in item 59 (types of funding sought)]
Did you seek funding or support for this [NSF/I-Corps] project from any of the following nongovernment sources?
•
Self-investment in the business entity
•
Bootstrap or crowd-funding
•
Individual private investment from non-accredited investor(s) (e.g., family, friends, etc.)
•
Incubator or accelerator direct financing or equity exchange
•
Debt financing (e.g., SBA loan or convertible debt instrument)
•
Accredited angel investor or group
•
Non-corporate institutional venture capital/seed stage funding
•
Corporate venture capital/seed stage funding
•
Funding from foundations and non-profits
•
Other (specify)

16

65

I-Corps
Only

66

I-Corps
Only

[If selected "Self investment in the business entity" in item 59 (types of non-government funding
sought)]
Please enter as much information as you can about your self-investment in this I-Corps project.
Amount
Date received
Description/Source
(mm/yyyy)
(optional)
1.
2.
3.
4.
5.
6.
[If selected "Bootstrap or crowd-funding " in item 59 (types of non-government funding sought)]
Please enter as much information as you can about your I-Corps project's bootstrap or crowd-funding
activities.
Amount
Date received
Description/Source
(mm/yyyy)
(optional)
1.
2.
3.
4.
5.
6.

67

I-Corps
Only

[If selected "Individual private investment from non-accredited investor(s) (e.g., family, friends, etc.)"
in item 59 (types of non-government funding sought)]
Please enter as much information as you can about your I-Corps project's funding from individual
private investment from non-accredited investors.
Amount
Date received
Description/Source
(mm/yyyy)
(optional)
1.
2.
3.
4.
5.
6.

68

I-Corps
Only

[If selected "Incubator or accelerator direct financing or equity exchange" in item 59 (types of nongovernment funding sought)]
Please enter as much information as you can about your I-Corps project's funding from incubator or
accelerator direct financing or equity exchange.
Amount
Date received
Description/Source
(mm/yyyy)
(optional)
1.
2.
3.
4.
5.
6.

17

69

I-Corps
Only

70

I-Corps
Only

71

I-Corps
Only

73

I-Corps
Only

[If selected "Debt financing (e.g., SBA loan or convertible debt instrument)" in item 59 (types of nongovernment funding sought)]
Please enter as much information as you can about your I-Corps project's funding from debt financing.
Amount
Date received
Description/Source
(mm/yyyy)
(optional)
1.
2.
3.
4.
5.
6.
[If selected "Accredited angel investor or group" in item 59 (types of non-government funding sought)]
Please enter as much information as you can about your I-Corps project's funding from accredited
angel investors or groups.
Amount
Date received
Description/Source
(mm/yyyy)
(optional)
1.
2.
3.
4.
5.
6.
[If selected "Corporate institutional venture capital/seed stage funding" in item 59 (types of nongovernment funding sought)]
Please enter as much information as you can about your I-Corps project's funding from corporate
venture capital and/or seed stage sources.
Amount
Date received
Description/Source
(mm/yyyy)
(optional)
1.
2.
3.
4.
5.
6.
[If selected "Funding from foundations and non-profits" in item 59 (types of non-government funding
sought)]
Please enter as much information as you can about your I-Corps project's funding from foundations
and non-profits.
Amount
Date received
Description/Source
(mm/yyyy)
(optional)
1.
2.
3.
4.
5.
6.
Planned funding

18

74

I-Corps
Only

[If item 11(involvement with I-Corps project) response is "yes, I continued to be involved with the
project"]
Will you seek funding for this I-Corps project from any of the following sources in the next 12 months?
•
Federal government funding
•
State or regional government funding
•
Non-government funding
•
I will not seek funding
Planned Government Funding

75

I-Corps
Only

76

I-Corps
Only

77

I-Corps
Only

[If "Federal government funding" is selected in item 74 (types of funding you will seek)]
Which NSF awards, if any, will you apply for based on your I-Corps project in the next 12 months?
•
Small Business Innovation Research (SBIR) Phase I Small Business Innovation Research (SBIR)
Phase I
•
Small Business Innovation Research (SBIR) Phase II
•
Small Business Technology Transfer Program (STTR) Phase I
•
Small Business Technology Transfer Program (STTR) Phase II
•
Accelerating Innovation Research/Partnerships for Innovation (AIR/PFI)
•
Engineering Research Center (ERC)
•
Grant Opportunities for Academic Liaison with Industry (GOALI)
•
Science and Technology Centers (STC)
[If "Federal government funding" is selected in item 74 (types of funding you will seek)]
Which other agencies, if any, will you apply to for SBIR/STTR awards based on your I-Corps project in
the next 12 months?
•
Department of Agriculture
•
Department of Commerce
•
Department of Defense
•
Department of Education
•
Department of Energy
•
Department of Health and Human Services/National Institutes of Health
•
Department of Homeland Security
•
Department of Transportation
•
Environmental Protection Agency
•
National Aeronautics and Space Administration
•
National Institute of Standards and Technology
•
National Oceanic and Atmospheric Administration
[If " Non-government funding" is selected in item 74 (types of funding you will seek)]
Will you seek funding or support for this I-Corps project from any of the following sources in the next
12 months?
•
Self-investment in the business entity
•
Bootstrap or crowd-funding
•
Individual private investment from non-accredited investor(s) (e.g., family, friends, etc.)
•
Incubator or accelerator direct financing or equity exchange
•
Debt financing (e.g., SBA loan or convertible debt instrument)
•
Accredited angel investor or group
•
Non-corporate institutional venture capital/seed stage funding
•
Corporate venture capital/seed stage funding
•
Funding from foundations and non-profits
•
Other (specify)
Incubator or Accelerator Support

78

All

Has your [NSF/I-Corps] project participated in or received non-financial incubator or accelerator
support?
•
Yes
•
No [go to item 84]

19

79

I-Corps
Only

[If response to Item 78 (non-financial incubator or accelerator support) is "yes"]
Please list the incubators or accelerators your I-Corps project has been affiliated with.
Name
Dates affiliated
Description
1.
2.
3.
4.
5.
6.

80

Please check the types of support your NSF project has received from incubators or accelerators.
•
Physical office space
•
Wet labs/bench space
•
Training and/or mentorship
•
Access to investment network(s)
•
Other (specify):
Past Incubator or Accelerator Support

81

I-Corps
Only

82

I-Corps
Only

[If item 11 (involvement with I-Corps project) response is "yes, I continued to be involved with the
project" AND Item 13 (whether project is active) response is "No"]
Did your I-Corps project participate in or receive non-financial incubator or accelerator support?
•
Yes
•
No
[If response to item 68 (past non-financial incubator or accelerator support) is "Yes"]
Please list the incubators or accelerators your I-Corps project was affiliated with.
Name
Dates affiliated
Description
1.
2.
3.
4.
5.
6.

83

I-Corps
Only

[If response to item 78 (past non-financial incubator or accelerator support) is "Yes"]
Please check the types of support your I-Corps project received from incubators or accelerators.
•
Physical office space
•
Wet labs/bench space
•
Training and/or mentorship
•
Access to investment network(s)
•
Other (specify):
Commercialized

84

All

Are there any products, services, or processes in the market, market ready, or awaiting regulatory
approval whose commercialization you can attribute (to some degree) to your [NSF/I-Corps] project?
•
Yes
•
No [go to item 86]
Sales of New Products, Services, or Processes

20

85

All (non-ICorps only
items with
***)

[If response to item 84 (commercialization) Is "Yes"]
Please enter the following information about these products, services or processes.

Description***

85.1

NSF ICorps only

Status
***(idea/concept,
prototype, ready
for sale, or selling
to customers)

Number of units
sold (if any)

Amount of sales
since
commercialization

Amount of sales
in last fiscal year

1.
2.
3.
4.
5.
6
[If response to item 84 is “Yes”] Did the experience with original technology and I-Corps result in spinoffs, new ideas, or products?
•
Yes
•
No
Regulatory Approval

86

I-Corps
Only

87

I-Corps
Only

[If response to company sector is "Healthcare/Medical" and company is active]
How many regulatory filings do you have for your I-Corps technology? Enter "0" if none.
Text box
[If response to # of regulatory filings is >0]
Select the options that best describe the regulatory approval status of the technology from your ICorps course.
Planned

Submitted

Approved

Rejected

○
○
○

○
○
○

○
○
○

○
○
○

Not
applicable
○
○
○

○
○

○
○

○
○

○
○

○
○

○
○
○
○

○
○
○
○

○
○
○
○

○
○
○
○

○
○
○
○

Premarket Approval (PMA)
501(k) Premarket Notification
Investigational Device Exemption
(IDE)
Biologics License Application (BLA)
Investigational New Drug
Application (IND)
New Drug Application (NDA)
FDA facility regulations
European Conformity (CE) Mark
Other

88

I-Corps
Only

[If response to # of regulatory filings is >0]
Please describe the other types of regulatory approval your technology from the I-Corps course has
applied for. Open-ended
Reimbursement Approval

89

I-Corps
Only

[If response to # of regulatory filings is >0]
Please indicate how many of the technologies from your I-Corps course are in each stage of the
reimbursement approval status process.

Centers for Medicare &
Medicaid Services (CMS)
Private payer
Other

Planned

Submitted

Approved

Rejected

○

○

○

○

Not
applicable
○

○
○

○
○

○
○

○
○

○
○

Clinical Trials

21

90

I-Corps
Only

91

I-Corps
Only

[If response to company sector is "Healthcare/Medical" and company is active]
How many clinical trials has the technology you worked on in the I-Corps course had?
Text box
[If response to company sector is "Healthcare/Medical" and company is active]
Please indicate the number of clinical trials for the technology you worked on in your I-Corps course.
Planned

Ongoing

Completed

Phase I clinical trial
Phase II clinical trial
Phase III clinical trial
Early feasibility
Feasibility/pilot
Pivotal
Premarket approval (PMA) device trial

○
○
○
○
○
○
○

○
○
○
○
○
○
○

○
○
○
○
○
○
○

Not
applicable
○
○
○
○
○
○
○

Phase IV Postmarketing study
Outside of the United States (OUS)

○
○

○
○

○
○

○
○

Publications
93

I-Corps
Only

94

I-Corps
Only

95

I-Corps
Only

["If response to item 13 (whether company is active) is "yes"]
Please indicate the number of times the company name has been affiliated with a peer-reviewed
publication:
Numeric: open
[If response to the number of times the company name has been affiliated with a peer-reviewed
publication is >0]
Have any of these publications resulted from development of the technology supported by I-Corps?
•
Yes
•
No
Generated Revenue
[If item 11 (involvement with I-Corps project) response is "yes, I continued to be involved with the
project"]
[After your I-Corps course ended], was licensing revenue generated from the product, service or
process you developed?
•
Yes
•
No [go to item 98]
Licensing Revenue

96

I-Corps
Only

97

I-Corps
Only

[If response to item 95 (any licensing revenue generated) is "Yes"]
Please estimate the amount of licensing revenue generated from products, services or processes.
Numeric field
[If response to item 96 (licensing revenue amount) is >0]
Please estimate the percentage of total revenue gained from licensing.
Numeric Field
New Ventures

100

101

All

I-Corps
Only

[Many participants who have completed the I-Corps course have gone on to form new ventures
unrelated to their I-Corps projects.]
Are you currently pursuing a new venture?
•
Yes
•
No
[If response to item 100 (new venture) is "Yes"]
What is the name of this new venture?
Text box

22

102

I-Corps
Only

103

I-Corps
Only

[If response to item 100 (new venture) is "Yes"]
Are you using Osterwalder's Business Model Canvas in your new venture?
•
Yes
•
No
[If response to item 100 (new venture) is "Yes"]
Are you using the customer discovery process in your new venture?
•
Yes
•
No
Other Outcomes

104

NSF ICorps
Only

[If Time 1 response]
In 2014, you gave us the following information on entrepreneurial curricula you had developed since
participating in the I-Corps course:
Course number: [TIME 1 RESPONSE]
Course title: [TIME 1 RESPONSE]
Course description: [TIME 1 RESPONSE]

105

All except
for I-Corps
@ NIH

106

NSF ICorps only

107

All except
for I-Corps
@ NIH

Have you developed any additional entrepreneurial curricula?
•
Yes
•
No
[I-Corps: For all respondents with no Time 1 response to this question.]
Since [the start of your commercialization effort/participating in the I-Corps course], have you
developed any entrepreneurial curricula?
•
Yes
•
No
[If response to item 105 (entrepreneurial curricula developed) is "Yes" Or updating Time 1 response]
Please share the course number (if possible), title, and brief description of the course(s).
•
Course number
•
Course title
•
Organization
•
Course description
Did the [NSF/I-Corps] award lead to any of the following collaborations between you and the external
community?

Industry
Investors
Local or state government
Non-profit organization
Other

Yes
○
○
○
○
○

No
○
○
○
○
○

107.1

All except
for I-Corps
@ NIH

[If response to item 107 is “Yes” for “Other”] Please identify any other collaborations between you and
the external community. (open-ended text box)

108

All except
for I-Corps
@ NIH
All except
for I-Corps
@ NIH

[If response is "Yes "for "Industry" in item 107 (individual collaborations)]
Please describe your industry collaboration(s).

109

[If response is "Yes "for "Industry" in item 107 (individual collaborations)]
What do you gain from your collaborations with industry?
•
Opportunities to advance the commercialization of your research
•
Opportunities to advance your research agenda
•
Neither of the above
•
Other (specify)

23

110

All except
for I-Corps
@ NIH

111

All except
for I-Corps
@ NIH

111.1

All except
for I-Corps
@ NIH

Did your [NSF/I-Corps] project lead to any collaborations between the university you are currently
affiliated with and the external community?
•
Yes
•
No
•
I am no longer affiliated with a university
[If response is "Yes" for item 110 (university collaborations)]
Which of the following collaborations between the university you are currently affiliated with and the
external community did the [NSF/I-Corps] award lead to?
Yes
Uncertain
No
Industry
○
○
○
Investors
○
○
○
Local or State
○
○
○
Government
Non-profit organization
○
○
○
Other
○
○
○
[If response to item 111 is “Yes” for “Other”] Please identify any other collaborations between your
university and the external community.
Opportunities

112

All except
for I-Corps
@ NIH

Which, if any, of the following did you personally experience as a result of your interactions during the
[COURSE YEAR, SEASON, AND NODE] I-Corps course? Multiple choice
Customer Interviews
Instructor Engagements
Interactions with your team's EL(s) or PI(s)
Interactions with your team's mentor(s)
Interactions with other teams' ELs or PIs
Interactions with other teams' mentors
Other interactions (please describe)

113

I-Corps
Only

I-Corps @
NIH Only

113.2

I-Corps @
NIH Only

Accepted a job
offer
□
□
□
□
□
□
□

Other opportunity
□
□
□
□
□
□
□

Which, if any, of the following did your team or company receive as a result of interactions during the
[COURSE YEAR, SEASON, AND NODE] I-Corps course? Multiple choice.
Customer Interviews
Instructor Engagements
Interactions with your team's EL(s) or PI(s)
Interactions with your team's mentor(s)
Interactions with other teams' ELs or PIs
Interactions with other teams' mentors
Other interactions (please describe)

113.1

Received a job
offer
□
□
□
□
□
□
□

Received a job
offer
□
□
□
□
□
□
□

Accepted a job
offer
□
□
□
□
□
□
□

Other opportunity
□
□
□
□
□
□
□

Were you working as a consultant during the [course name] I-Corps at NIH course?
•
Yes
•
No
[If response to item 113.1 is “Yes”] Do you incorporate lessons learned in your I-Corps at NIH course
into your current work with consulting clients?
•
Yes
•
No
•
I no longer work as a consultant
Current Employment

114

All except
I-Corps @
NIH

Do you currently work for a college or university?
•
Yes
•
No [go to item 126]
•
Not currently employed [go to item 126]

24

115

All

116

All

117

I-Corps
only

118

I-Corps
only

119

All

120

I-Corps
Only
I-Corps
Only

121

Do you currently work for a college or university”?
•
Yes, I am primarily employed at a college or university.
•
Yes, I work at a college or university as well as a private company.
•
No, I work outside of academia.
•
No, I am not currently employed.
[If response is “Yes” in item 114]
Which of the following best describes your current role? Multiple choice.
•
Tenured faculty member
•
Faculty member on track for Tenure and Promotion
•
Non-tenured Faculty
•
Non-traditional university appointment (e.g., Professor of Practice, Visiting Scholar, etc.)
•
Research scientist
•
University Leader (Dean, Provost, etc.)
•
Administrative Staff (Academic Advisor, Center Director, etc.)
•
Student
•
Other (specify):
[If response to item 114 (whether currently working for college or university) is "No, I work outside of
academia." or "Yes, I work at a college or university as well as a private company."]
Which of the following best describes your current employer’s primary industry?
•
Agriculture
•
Education
•
Energy & Materials
•
Environment
•
Healthcare/Medical
•
Information Technology and Communications
•
Infrastructure/Building
•
Sanitation/Water
•
Not applicable
•
Other (specify)
[If response to item 114 (whether currently working for college or university) is "No, I work outside of
academia." or "Yes, I work at a college or university as well as a private company."]
Which of the following best describes your current employer’s company size?
•
1-10 employees
•
11-50 employees
•
51-200 employees
•
201-500 employees
•
501-1000 employees
•
More than 1000 employees
•
Other (specify)
[If response is “No, I work outside of academia.“ in item 114]
Did your work [in I-Corps/with commercializing your research] lead to your current employment?
•
Yes
•
No
•
Unsure
[If response to item 119 (work in I-Corps leading to current employment) is "Yes" or "Unsure"]
Please explain:
[If response to item 114 (whether currently working for college or university) is "No" or "Yes"
(that is, if respondent indicated that they are employed)]
In what ways, if any, has I-Corps influenced your career?
Text Box
Other I-Corps Experiences

25

122

I-Corps
Only

Have you participated in another national I-Corps team in addition to [TEAM NAME]?
•
Yes
•
No [go to item 126]

123

I-Corps
Only

[If response to item 122 (other national team participation) is "Yes"]
Please share some information on the other team(s) you have participated in.
Team name(s)
Team company(ies)
Team 1
Team 2
Team 3

124

I-Corps
Only

125

I-Corps
Only

125.1

I-Corps
Only

Which course(s)
attended

[If response to item 122 (other national team participation) is "Yes"]
Did the team(s) raise any government funding?
Please describe, including funding type (SBIR, PFI:AIR TT, etc.)
[If response to item 122 (other national team participation) is "Yes"]
Did the team(s) raise any private funding?
Please describe.
Involvement in I-Corps after the training can take many forms, from encouraging colleagues to apply
to the program to offering advice on SBIR applications.
In what ways, if any, do you still share information learned in the I-Corps course with your
department, colleagues, or other work-related connections? (open-ended text box)
Demographics

126

All except
I-Corps @
NIH

127

All except
I-Corps @
NIH

128

All except
I-Corps @
NIH

129

All except
I-Corps @
NIH

130

All except
I-Corps @
NIH
All except
I-Corps @
NIH

131

What is your current gender identity?
•
Male
•
Female
•
Another identity
•
Prefer not to answer
What is your date of birth?
Date dropdown (month, day, year)
Help text: If you prefer not to answer, please leave the field blank.
What is your race? (Select one or more) American Indian or Alaska Native
•
Asian
•
Black or African American
•
Native Hawaiian or Other Pacific Islander
•
White
•
Other
•
Prefer not to answer
Are you of Hispanic, Latino, or Spanish origin?
•
Yes
•
No
•
Prefer not to answer
How do you describe your country of national identification?
Country dropdown
Help text: National identification is defined as the country with which you primarily associate.
Have you ever served on active duty in the U.S. Armed Forces, Reserves, or National Guard?
•
Never served in the military
•
Only on active duty for training in the Reserves or National Guard
•
Now on active duty
•
On active duty in the past, but not now
•
Prefer not to answer

26

132

All except
I-Corps @
NIH

Please select yes if any of the following apply to you.

Deaf or serious difficulty hearing
Blind or serious difficulty seeing even when wearing glasses
Serious difficulty walking or climbing stairs
Other serious disability related to a physical, mental, or
emotional condition

Yes

No

○
○
○
○

○
○
○
○

Prefer not
to answer
○
○
○
○

Anything Else
133

All

[If yes to item 2]
Thanks for your responses! Is there anything else you would like us to know about your [ICorps/commercialization] experience that wasn't captured by this survey?
[TEXT BOX]

27