Women's Business Center Clients
Women's Business Center Clients
AppendixA1 WBC Client Outcome Survey English_revised_10-9-19
Women's Business Center Clients
OMB: 3245-0402
Appendix A1. WBC Client Outcome Survey- English
Women's Business Center Client
Outcome Survey
English Version
September 2019
Sponsored by:
U.S. Small Business Administration
We appreciate you taking a few minutes to answer some brief questions about the assistance you received from the [WBC Name] during calendar year 2017. This survey is intended to solely focus on your experience in 2017, not 2018. This is to allow lag time needed to measure the impact on your business outcomes.
The Small Business Administration has contracted with a private research firm, 2M Research (2M), to develop and administer this survey. All responses to these questions are voluntary. The data will be held in strict confidence and reported only in the aggregate without identifying any individual respondent. Individual data will be maintained by 2M and SBA. It will not be released to the [WBC name], to other government agencies, or to other private firms.
If you have any questions about this study or would like to complete the survey over the phone, please contact the study team by email at womensbusiness@2mresearch.com or by phone at 1-800-XXX-XXXX (toll-free) from 9:00 a.m. to 4:00 p.m. CST Monday through Friday. If you call outside of this time, please leave a message and we will return your call the following business day.
According
to the Paperwork Reduction Act of 1995, an agency may not conduct or
sponsor, and a person is not required to respond to, a collection of
information unless it displays a valid OMB control number. The valid
OMB control number for this information collection is XXXX-XXXX. The
time required to complete this information collection is estimated
to average 6
minutes per response,
including the time for reviewing instructions, searching existing
data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. Send
comments regarding this burden estimate or any other aspect of this
collection of information, including suggestions for reducing this
burden, to: U.S.
Small Business Administration, Director, Records Management
Division, 409 3rd St., S.W., Washington, DC 20416 and Desk Officer
for the Small Business Administration, Office of Management and
Budget, New Executive Building, Room 10202, Washington, DC 20503
instructions
You may move forward through the questions by clicking on the “Next” button on the bottom right of the screen, and you may always go back and change an answer by clicking on the “Back” button on the bottom left. Your answers will automatically save as you click forward to move on to the next question. Hovering your cursor over highlighted text will show more information about the term.
If you would like to exit the survey, click on the “X” on the top right and come back a later time. The survey can be accessed at a later time by clicking on the survey link that was provided to you in the email notifying you of the survey.
When you reach the end of the survey, click “Submit.”
Assistance received
When did you first contact the [WBC name]?
_____________ [year drop down selection]
What type of business assistance or training did you receive through the [WBC name] during 2017?
□ Classroom training
□ Online training
□ One-on-one counseling
□ Referral or connection to an affiliate of the [WBC name] for consultation, coaching, etc.
□ None
2a. Please describe the other type of business assistance or training you received through the [WBC name].
Please estimate how many total hours of business assistance and training you received during 2017.
□ Less than 1 hour
□ 1–2 hours
□ 3–5 hours
□ 6–8 hours
□ 9–10 hours
□ More than 10 hours
Did you receive business assistance or training through other organizations during 2017? Select all that apply
□ Yes, a Small Business Development Center
□ Yes, a SCORE chapter
□ Yes, Other [ANSWER Q4a]
□ No
□ Do not know
4a. Please provide the name(s) of the other organization(s) you received business assistance or training through during 2017.
Have you received business assistance or training through the [WBC name] or another organization since 2017?
□ Yes
□ No
□ Do not know
Assistance Impact
As a result of the assistance or training you received through the [WBC name], have you changed any of your business decisions, practices, or strategies?
□ Yes
□ No
□ Do not know
To what extent do you agree or disagree with the following statements?
|
Strongly Agree |
Agree |
Neither Agree nor Disagree |
Disagree |
Strongly Disagree |
Not Applicable |
My experience with the [WBC name] helped me to: Increase my confidence |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Access a trusted advisor |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Increase my self-sufficiency |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Start/increase my savings |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Consider growing my business |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Increase my household income |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
To what extent do you agree or disagree with the following statements? If you have not yet started or had sought assistance to close or sell your business, please skip to question 9.
|
Strongly Agree |
Agree |
Neither Agree nor Disagree |
Disagree |
Strongly Disagree |
Not Applicable |
The assistance I received from the [WBC name] helped me to: Start my business |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Increase my sales |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Obtain financing |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Increase my profit margin |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Hire new staff |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
Other, if any [ANSWER 8a] |
☐ |
☐ |
☐ |
☐ |
☐ |
☐ |
8a. Please Specify Other
Overall, how helpful were the services you received through the [WBC name]?
□ Very helpful
□ Somewhat helpful
□ Slightly helpful
Would you recommend the [WBC name] to a friend or business associate?
□ Yes
□ No
Getting Started
When you sought assistance from the [WBC name] in 2017, were you:
Hover over options for more information.
□ Just considering a business idea [GO TO Q14]
□ In the process of starting or acquiring a business [GO TO Q14]
When did you start or acquire your business?
___________ [year drop down selection]
In the year selected above, what month did you start your business?
____________ [month drop down selection] [GO TO Q16]
□ Do not know [GO TO Q16]
Did you start or acquire your business during or since 2017?
□ Yes [GO TO Q16]
□ No
If you are no longer actively engaged in starting this business, what is the primary reason?
□ Personal circumstances (e.g., health reasons, no longer interested) [GO TO Q23]
□ Lack of time [GO TO Q23]
□ Inadequate business assistance or training from the [WBC name] [GO TO Q23]
□ Insufficient start-up capital [GO TO Q23]
□ Business (idea) was not financially viable [GO TO Q23]
□ Other [ANSWER Q15a]
□ I am still actively engaged in starting this business [GO TO Q23]
15a. Please describe the other primary reason. [GO TO Q23]
Are you currently operating this business?
□ Yes [GO TO Q18]
□ No
What is the primary reason you are no longer operating this business?
□ Business was not financially viable
□ Personal circumstances (e.g., prefer a wage job, illness, moved)
□ Business was sold
□ Other [ANSWER Q17a]
17a. Please Specify Other
Which of the following best describes the industry or sector of your business?
□ Personal service (e.g., salon, computer repair, wedding planning)
□ Professional service (e.g., accounting, management consulting, technology)
□ Educational service (e.g., school, trade program, test preparation service)
□ Social assistance and healthcare (e.g., day care, youth services, community food services, health services)
□ Construction (e.g., plumbing, electrician, construction)
□ Retail trade (e.g., clothing, florist, convenience store, car dealer)
□ Hospitality, art, entertainment (e.g., restaurant, lodging, event promotion, performing arts)
□ Manufacturing (e.g., food, furniture, clothing)
□ Other [ANSWER Q18a]
18a. How would you best describe your industry or sector?
Which of the following best describes the primary geographic location of your business?
□ Rural area
□ Urban area
□ Suburban area
Business Statistics
Were you operating your business during any part of 2017 or 2018?
□ I was operating my business for all or parts of BOTH 2017 and 2018.
□ I was operating my business for all or parts of 2017 only.
□ I was operating my business for all or parts of 2018 only.
□ I was not operating my business during any part of 2017 of 2018.
What was the approximate gross sales revenue of the business during each of the calendar years below? Please complete only for the years you operated; leave others blank.
All data will be held in strict confidence and reported only in the aggregate without identifying any individual respondent.
2017: $____________
2018: $____________
At the end of the following calendar year(s) how many paid employees (including paid owners) did the business have?
Please complete only for the years you operated; leave others blank.
If you applied for new debt or equity financing (e.g., a loan) for your business in 2017 or 2018, what was the primary reason?
□ To start or acquire my business
□ To accommodate growth in my business
□ To support cash flow
□ To replace a capital asset
□ Other [ANSWER Q23a]
□ I did not apply for new financing [GO TO Q26]
23a. Please describe the other primary reason you applied for financing for your business in 2017 or 2018.
Did you obtain new debt or equity financing for your business in 2017 or 2018?
□ Yes
□ No [GO TO Q26]
Estimate the total amount of new debt or equity financing your business obtained from the following sources in 2017 and 2018.
All data will be held in strict confidence and reported only in the aggregate without identifying any individual respondent.
Small Business Administration (SBA) guaranteed loan (e.g., 7(a), disaster) $____,____.00
Non-SBA loan from the [WBC name] partner organization $____,____.00
Non-SBA loan from a commercial bank or credit union $____,____.00
Non-SBA loan from a community lender or non-bank $____,____.00
Non-SBA loan from an online lender (e.g., Lending Club) $____,____.00
Non-SBA loan from friends or family $____,____.00
Other debt acquired or investor equity raised [ANSWER Q25a] $____,____.00
25a. If other new debt was acquired or investor equity was raised, please describe.
Background Information
Please indicate your sex
□ Female
□ Male
Which best describes your military experience:
□ No military, Reserve, or National Guard experience
□ Veteran
□ Service Disabled Veteran
□ Active Military
□ Retired or not currently active military, Reserve, or National Guard
Do you consider yourself a person with a disability?
□ Yes
□ No
Are you of Hispanic or Latino origin?
□ Yes, I am of Hispanic or Latino origin
□ No, I am not of Hispanic or Latino origin
Please indicate your race or origin:
Select all that apply
□ American Indian or Alaskan Native
□ Black or African American
□ Native Hawaiian or Other Pacific Islander
□ White
Please indicate your current age:
□ 18–24
□ 25–34
□ 35–44
□ 45–54
□ 55–64
□ 65–74
□ 75+
At the time that you first sought services from the [WBC name], what was your employment status?
□ Self-employed
□ Employed full-time for another company
□ Employed part-time for another company
□ Unemployed
□ Other
At the time that you first sought services from the [WBC name], how many adults and children were living in your household?
□ 1
□ 2
□ 3
□ 4
□ 5
□ 6
□ More than 6
At the time that you first sought services from the [WBC name], what was your approximate total household income?
□ Less than $12,000
□ $12,000–$16,000
□ $16,001–$20,000
□ $24,001–$50,000
□ More than $50,000
WRAP-UP
Is there anything else you would like to share about yourself, your business, your experience with the [WBC name], or ways to improve the program?
Thank you for participating in the survey. Please click “Submit.”
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Saara Hussain |
| File Modified | 0000-00-00 |
| File Created | 2021-01-15 |
© 2024 OMB.report | Privacy Policy