G406: GIPA Domestic Survey

OMB Control No.: 0651-0080
Expiration Date: XX/XX/XXXX

Outreach Short Survey - OMB Approval - Net
Promoter Score Question #2

1. Pleaser enter the date attended.

Event Date
Date

MM/DD/YYYY

2. How likely is it that you would recommend the (workshop, seminar, conference,
program, or event) to a friend or colleague?
Not at all likely
0

1

Extremely likely
2

3

4

5

6

7

8

9

10

3. Overall, how satisfied or dissatisfied are you with the (workshop, seminar,
conference, program, or event)?
Very satisfied

Dissatisfied

Satisfied

Very dissatisfied

Neither satisfied nor dissatisfied

4. This (workshop, seminar, conference, program, or event) enhanced my
understanding of the topic?
Strongly agree

Disagree

Agree

Strongly disagree

Neither agree nor disagree

5. This (workshop, seminar, conference, program, or event) enhanced my
understanding of the topic.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with
an information collection subject to the requirements of the Paperwork Reduction Act of 1995, unless the information collection has a valid OMB Control
Number. The OMB Control Number for this information collection is 0651-0080. Public burden for this survey is estimated to average 5 mintues per
response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the information collection. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions
for reducing this burden to the Office of the Chief Administrative Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA
22313-1450 or email InformationCollection@uspto.gov.

6. Based on the information presented to you, how likely would you be to use the
information from the (workshop, seminar, conference, program, or event)?
Very likely
Likely
Neither likely nor unlikely
Unlikely
Very unlikely

7. How did you hear about the (workshop, seminar, conference, program, or event)?
Check all that apply.
USPTO.gov website

Email announcement

Social media (e.g., Facebook, Twitter)

Colleague / Friend

Host other than USPTO

Attendance at a previous event

Other (please specify)

8. Please share any other comments you have below:

Thank you for taking this survey.

This program is presented by the USPTO’s Global Intellectual Property Academy, a unit of the Office of Policy
and International Affairs (OPIA). OPIA assists the Under Secretary of Commerce for Intellectual Property and
Director of the USPTO in advising the President (through the Secretary of Commerce) and federal agencies
on domestic and international IP issues as well as on U.S. treaty obligations. It also provides technical
assistance and training on IP-related matters to U.S. stakeholders and both U.S. and foreign government
officials.
Survey Instructions
Approved for use through XX/XX/XXXX. OMB 0651-0080
U.S. Patent and Trademark Office; U.S. DEPARTMENT OF COMMERCE
Under the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it contains a valid OMB control number.
PRA Act Statement:
A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person
be subject to a penalty for failure to comply with an information collection subject to the requirements of the
Paperwork Reduction Act of 1995, unless the information collection has a currently valid OMB Control
Number. The OMB Control Number for this information collection is 0651-0080. Public burden for this form is
estimated to average 15 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering and maintaining the data needed, and completing and reviewing the
information collection. Response to this information collection is voluntary; however, it allows the USPTO to
analyze the overall effectiveness of the program. Send comments regarding this burden estimate or any
other aspect of this information collection, including suggestions for reducing this burden to the Chief
Administrative Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 223131450 or email InformationCollection@uspto.gov.