Improvement of NSF/NIH I-CORPS Longitudinal Outcomes Survey

Appendix B: Omnibus NSF Engineering Longitudinal Survey
Instrument Time 2
Respondent

Questions and Skip Logic

Survey Screener
A.1.

Non-I-Corps
PIs only

A.2.

Non-I-Corps
PIs only

A.3.

Non-I-Corps
PIs only

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

Yes [Exit Survey]
No [proceed to A.2.]

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

Yes [Exit Survey]
No [proceed to A.3.]

Have you ever explored opportunities to commercialize any aspect of your NSF-funded research?
o
o

Yes [proceed to A.4.]
No [proceed to A.4.]

When exploring the commercialization of your NSF-funded research, did you ever:
[If no to A.3.] Have you ever done any of the following?

A.4.

Non-I-Corps
PIs only

4a

Participate in entrepreneurial training?

4b

Apply for governmental or institutional grants to
promote commercialization?

4c

Seek advice on commercializing my research?

4d

Explore commercialization opportunities in other
ways?

o
o
o
o

Yes
No
Yes
No

o
o
o
o

Yes
No
Yes (Please specify)
No

Your NSF-funded research
In this survey, we will ask about your experience pursuing commercialization of NSF-funded
research. You will need to identify one NSF-funded project with the most commercial potential or
one that you spent most time in commercializing. In the remainder of the survey, we will refer to
this project as “your NSF project.”
B.1.

Non-I-Corps
PIs only

Thinking back to your NSF grant(s), identify one research project that led you to explore related
opportunities to commercialize products, services or technologies. If you have multiple projects
that meet these criteria, please focus on the one that you think has advanced the most in terms of
commercialization.
Project Name: _______________________
Award ID: _______________________

7

Project Start Year: _______________________
Project End Year: _______________________
B.2.

Non-I-Corps
PIs only

In which year did you start the effort to commercialize your NSF project? YYYY
Indicate how many times you participated in each of the following experiences. Enter zero (0) if
you did not have any prior experience:
Prior to the start of
the effort to
commercialize your
NSF project

B.3.

Non-I-Corps
PIs only

B.4.

Non-I-Corps
PIs only

After to the start of
the effort to
commercialize your
NSF project

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 (forprofit, 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
What activities did you undertake when you explored commercialization of your NSF project?
(Select 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 office
Sought support from university technology transfer office
Represented or acted as a potential investor

Your Commercialization Effort
C.1.

Non-I-Corps
PIs only

Did you develop a formal written business strategy to guide your efforts to commercialize your
project?
o
o

Yes
No

8

[If yes to 4.a] Please identify the types of entrepreneurial training you received, the number of
times you participated and for what total amount of time.

I-Corps Courses (offered at I-Corps Site
or Node programs)

C.2.

How many
times?
o Never
o Once
o More than
once

Courses using Customer Discovery or
the Business Model Canvas

o Never
o Once
o More than
once

Accelerator Programs (e.g. Tech Stars or
Y Combinator)

o Never
o Once
o More than
once

Other Entrepreneurial educational
Programs

o Never
o Once
o More than
once

Non-I-Corps
PIs only

Total cumulative time for all
occurrences?
o Less than 1 day
o At least 1 day but less
than 1 week
o At least 1 week but less
than1 month
o At least 1 month but less
than 1 semester
o At least 1 semester but
less than 1 year
o 1 year or more
o Less than 1 day
o At least 1 day but less
than 1 week
o At least 1 week but less
than1 month
o At least 1 month but less
than 1 semester
o At least 1 semester but
less than 1 year
o 1 year or more
o Less than 1 day
o At least 1 day but less
than 1 week
o At least 1 week but less
than1 month
o At least 1 month but less
than 1 semester
o At least 1 semester but
less than 1 year
o 1 year or more
o Less than 1 day
o At least 1 day but less
than 1 week
o At least 1 week but less
than1 month
o At least 1 month but less
than 1 semester
o At least 1 semester but
less than 1 year
o 1 year or more

9

C.3.

Non-I-Corps
PIs only

What other types of commercialization support have you or your team received?
Please choose all that apply:
One­on­one coaching
Group coaching
Peer support
University­based mentor
Industry­based mentor (other than I­Corps team mentor)
Other:
None

Your Team

In this section, we will obtain information about the individuals who 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., 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.
D.1.

Non-I-Corps
PIs only

When exploring the commercial opportunities associated with your NSF project, how many people
have you worked closely with?
o
o
o
o
o

1
2
3
4
5+

[Questions D2-D5 repeat depending on D1 answer]
D.2.

Non-I-Corps
PIs only

When did you start working with this person?
mm/yyyy
Are you still working with this person on the commercialization effort?

D.3.

Non-I-Corps
PIs only

D3.a.

Non-I-Corps
PIs only

D.4.

Non-I-Corps
PIs only

o
o

Yes
No

[if no] when did you stop working with this person on the commercialization effort?
mm/yyyy
Was this person a post-doctoral or graduate student at your institution or at an affiliated
institution?
o
o

Yes
No

10

What activities did this person undertake when working on the commercialization effort of your
NSF project? (Select all that apply)

D.5.

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 office
Sought support from university technology transfer office
Represented or acted as a potential investor

Non-I-Corps
PIs only

Are you familiar with the Osterwalder “Business Canvas Model’?
D.5.a.

o
o

Yes
No

Project Status

0

1

I-Corps
Teams only

I-Corps
Teams only

[Displayed for all]
This survey asks about your experiences as a(n) [ROLE] with the [TEAM NAME] team from
[INSTITUTION] in the [COURSE NAME] I-Corps course, the same team you updated us on in the
first I-Corps Longitudinal Outcomes Survey.
Please note: if you have participated in other I-Corps teams in addition to the team above, there
will be space at the end of the survey to share your other experiences. Please fill out all other
questions for the [TEAM NAME] team.
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.
o Yes, I continued to be involved with the project
o No, I stopped being involved with the project.
Make a comment on your choice here:

2

3

I-Corps
Teams only

[If item 1 (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:____________

I-Corps
Teams only

[If item 1 (involvement with I-Corps project) response is "yes, I continued to be involved with the
project"]
Is this project still active?
o Yes
o No
o Uncertain

11

4

5

6

7

I-Corps
Teams only

[If item 3 (whether project is active) response is "Uncertain"]
Select any of the reasons listed below that explain why you are uncertain.
o We have not yet identified a large enough market for our product/technology
o The time to get the technology into market may be too great
o We are encountering difficulties with our technology itself
o We have not yet obtained needed financing/investment to continue
o We are having problems with intellectual property
o We are having problems with our team
o Other

I-Corps
Teams only

[If item 3 (whether project is active) response is "No"]
Why is this project no longer active?
o We successfully commercialized our project
o We decided to discontinue pursuing commercialization for our project
o Other:

I-Corps
Teams only

[If item 1 (involvement with I-Corps project) is "yes" AND item 3 (whether project is active)
response is "No"]
We were not able to identify a large enough market for our product/technology
o The time to get the technology into market was too great
o We had problems with our intellectual property
o We encountered difficulties with the technology or product
o We could not obtain necessary financing/ investment to continue
o The company was acquired
o We had problems with our team

ALL

If item 1 (involvement with I-Corps project) is "yes" AND item 3 (whether project is active)
response is "Yes"
Which of the following best describes your project's current area of research or technology?
o Advanced Materials and Instrumentation (MI)
o Advanced Manufacturing and Nanotechnology (MN)
o Biological Technologies (BT)
o Chemical and Environmental Technologies (CT)
o Electronic Hardware, Robotics and Wireless Technologies (EW)
o Educational Technologies and Applications (EA)
o Information and Communication Technologies (IC)
o Semiconductors (S) and Photonic (PH) Devices and Materials
o Smart Health (SH) and Biomedical Technologies (BM)
o Other: Please Specify

Business Creation and Dissolution

8

ALL

[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?
o No company has been incorporated
o One or more companies have been incorporated
________________________________
[For non-I-Corps] Has a company been incorporated based on your NSF project?

12

o
o

Yes
No

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]
9

I-Corps

If any information needs to be updated, please Multiple choice.
If existing company in VW database (via intake/post responses, news forwarded from NSF project
officer, etc.)
o Name is incorrect
o Incorporation date is incorrect or needs to be added
o Website is incorrect or needs to be added

10

ALL

11

ALL

[If response to item 8 (company creation) is "one or more companies have been incorporated" or
“No” for non-I-Corps]
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 last active.
Text: open
[If response to item 8 (company creation) is "one or more companies have been incorporated"]
What is the URL of the company's website, if any?

[If response to item 8 (company creation) is "one or more companies have been incorporated"]
When was the company incorporated? (mm/dd/yyyy)

12

[If response to item 8 (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.)]
13

ALL

Is this company still operational?
o Yes
o No
["If response to item 13 (whether companis active) is "yes"]

27

ALL

What sector best describes this company?
o Agriculture
o Education
o Energy & Materials
o Environment
o Healthcare/Medical
o Information Technology and Communication

13

o
o
o

Infrastructure/Building
Sanitation/Water
Other

ALL

[If response to item 13 (whether company is operational) is "No"]
Approximately when did this company close or dissolve?
(mm/yyyy)

ALL

[If response to item 13 (whether company is operational) is "No"]
Why did the company close/dissolve?
o We were not able to identify a large enough market for our product/technology
o The time to get the technology into market was too great
o We had problems with our intellectual property
o We encountered difficulties with the technology or product
o We could not obtain necessary financing/investment to continue
o The company was acquired
o Other

I-Corps

[If existing company in VW database (via intake/post responses, news forwarded from NSF
project officer, etc.) AND Time 1 response to this question.]
Our records indicate that your company is a {Time 1 response to legal form}. Is this still correct?
o Yes
o No

I-Corps

[If response to item 8 (new company creation) is "one or more companies have been
incorporated" OR If response to item 17 (whether Time 1 response needs to be updated) is
"Yes"]
Which of the following best describes how the business was started.
o A new business, branch or subsidiary owned by an existing business
o A business inherited from someone else
o A new, Independent business created by a single person or a team of people
o The purchase of an existing business
o The purchase of a franchise
o An organization designed for social and charitable objectives and legally established as a
not-for-profit
o Other:

18

I-Corps

[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? *
o Yes
o No

20

I-Corps

[If response to item 8 (new company creation) is "one or more companies have been
incorporated"OR If response to item 18 (whether Time 1 company info is correct) is "No"]

15

14

17

19

14

Which form of legal status does your business currently have?
o 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.
o 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.
o 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.
o 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.
o 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.
o 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.
o Other:

21

I-Corps

[If response to item 8 (new company creation) is "one or more companies have been
incorporated" OR If response to item 18 (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?
o Yes
o No

22

I-Corps

[If response to item 8 (new company creation) is "one or more companies have been
incorporated"ORIf response to item 18 (whether Time 1 company info is correct) is "No"]
Which form of legal status did the business previously have?

Business Info

23

I-Corps

[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?
o Yes
o No

15

24

ALL

[If response to item 8 (new company creation) is "one or more companies have been
incorporated" OR “no” for non-I-Corps OR If response to item 23 (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
o The I-Corps EL
o The I-Corps Mentor
o Other:
________________________________
[For non-I-Corps]
o You
o Someone else (please specify).

25

All

[If response to item 24 (CEO of company) was "Other"]
Please indicate what industry or type of business the CEO is from.
Text box

I-Corps

[If response to item 8 (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?

ALL

["If response to item 8 (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?
o Agriculture
o Education
o Energy & Materials
o Environment
o Healthcare/Medical
o Information Technology and Communication
o Infrastructure/Building
o Sanitation/Water
o Other

I-Corps

[If response to item 8 (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?
o 1-10 employees
o 11-50 employees
o 51-200 employees
o 201-500 employees
o 501-1000 employees
o More than 1000 employees
o Other

26

27

28

16

["If response to item 13 (whether company is active) is "yes"]
Please select the items below that are true of your business.

ALL

Women are …
Socially disadvantaged
individuals are …

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."

I-Corps

29

I-Corps

["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
o Yes, and our 8(a) application is in process
o Yes, and we intend to apply for 8(a) certification
o Yes, and we do not intend to apply for 8(a) certification
o No, we do not meet the requirements
o Unsure
[If response to item 8 (new company creation) is "one or more companies have been
incorporated"ORIf 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?
o The I-Corps PI
o The I-Corps EL The I-Corps EL
o The I-Corps mentor The I-Corps mentor
o Equal shareholders (please describe)
o Other
[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:

30

I-Corps

[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
Is this information still correct?
o Yes
o No

31

I-Corps

[If response to item 8 (new company creation) is "one or more companies have been
incorporated" OR If response to item 30 (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?

17

32

I-Corps

[If response to item 8 (new company creation) is "one or more companies have been
incorporated"ORIf response to item 30 (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?
[By” helped to run the business” we mean that they provided regular assistance or advice with
day-to-day operations of the business, rather than providing only money or occasional operating
assistance.]
[If response to item 8 (new company creation) is "one or more companies have been
incorporated" OR If response to item 30 (whether Time 1 ownership and employees responses
are still correct) is "No"]

33

ALL

Not counting owner(s), how many people currently work for the business?
Full time employees***
Part time employees
*** Full time: working 35 hours or more per week.
Please exclude contract workers who work for the business either full- or part-time but are not
on the business’ official payroll.

Licensing

34

ALL

[If item 1 (involvement with I-Corps project) response is "yes, I continued to be involved with the
project" AND If response to item 30 (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? /
[For non-I-Corps] Have you engaged in any licensing activities associated with your NSF project?
o Yes
o No
[If Time 1 response] In 2014, you told us that {TOKEN:ATTRIBUTE_30} employee(s) worked in
areas related to product development or other activities arising from your I-Corps participation.

35

36

I-Corps

I-Corps

Is that still correct?
o Yes
o No
[If response to item 34 (licensing activities) is "Yes" OR If response to item 35 (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?

18

37

I-Corps

[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?
o Yes
o No
[If response to item 34 (licensing activities) is "Yes" OR If response to item 37 (whether Time 1
responses to patents, etc. were still correct) is "No"]

38

ALL

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 ICorps:
[Time 1 response] patents
[Time 1 response] copyrights
[Time 1 response] trademarks

39

I-Corps

Are these totals still correct?
*** Licensing out is licensing patents, copyrights, or trademarks owned by the business to other
parties under a licensing agreement.
o Yes
o No

19

40

ALL

[If response to item 34 (licensing activities) is "Yes" OR If response to item 39 (if Time 1 licensing
correct) is "No"]
B. [Since participation in the NSF-funded project], how many of the following has the business
licensed out?*** Enter "0" if none.
 Patents _____________
 Copyrights ___________
 Trademarks __________
 Trade Secrets _________
*** Licensing out is licensing patents, copyrights, or trademarks owned by the business to other
parties under a licensing agreement.

41

I-Corps

[If response to item 34 (licensing activities) is "Yes" OR If response to item 39 (if Time 1 licensing
correct) is "No"]
In 2014, you told us that your business had the following licensed in** since participating in ICorps:
{TOKEN:ATTRIBUTE_42} patents
{TOKEN:ATTRIBUTE_32} copyrights
{TOKEN:ATTRIBUTE_33} trademarks
Are these totals still correct?
o Yes
o 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.

42

ALL

[If response to item 34 (licensing activities) is "Yes" OR If response to item 39 (if Time 1 licensing
correct) is "No"]
How many patents, copyrights, or trademarks has the business licensed in ** since participating
in the NSF-funded project? Enter "0" if none.
 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.

Funding Routing

43

[If item 1 (involvement with I-Corps project) response is "yes, I continued to be involved with the
project"]
Did you seek funding for this I-Corps project from any of the following sources? Please Multiple
choice.
o Federal government funding
o State or regional government funding
o Non-government funding
o I did not seek funding

20

Government Funding

44

45

46

47

ALL

[If "Federal government funding" is selected in item 43 (types of funding sought)]
Please indicate the number of NSF awards you applied for based on your [I-Corps or NSF] project
[during or after the I-Corps course].
Small Business Innovation Research (SBIR)
Small Business Technology Transfer Program (STTR)
Accelerating Innovation Research/Partnership for Innovation (PFI:AIR)
Engineering Research Center (ERC)
Grant Opportunities for Academic Liaison with Industry (GOALI)
Science and Technology Centers (STC)

ALL (*** for
non-ICorps)

[If "Federal government funding" is selected in item 43 (types of funding sought)]
Please enter as much information as you can about your funded NSF proposals:
 Date Awarded (mm/yyyy) ***
 Phase, if SBIR/STTR ***
 Amount Awarded***
 Proposal Number
 Title
 PI name
 Company name (if applicable)

ALL

[If "Federal government funding" is selected in item 43 (types of funding sought)]
Which other agencies, if any, did you apply to for SBIR/STTR awards based on your I-Corps project
[during or after the I-Corps course (after [COURSE START DATE])]? Multiple choice.
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

ALL

[Follow-up question for each agency selected in item 47 (funding from federal agencies other
than NSF)]
Please indicate the number of [AGENCY NAME] SBIR/STTR awards you applied for based on your
I-Corps project.
 Total submitted
 In process (outcome unknown)
 Declined
 Funded

21

48

ALL (*** for
non-ICorps)

49

ALL

50

ALL

[Follow-up question for each agency selected in item 47 (funding from federal agencies other
than NSF)]
Please enter as much information as you can about your funded SBIR/STTR proposals from
[AGENCY NAME], if any.
 Date Awarded (mm/yyyy) ***
 Phase ***
 Amount Awarded ***
 Proposal Number
 Title
 PI name
 Company name (if applicable)
[If "State or regional government funding" is selected in item 43 (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
[If "State or regional government funding" is selected in item 43 (types of funding sought)]
If you received any additional government funding not covered above, please explain:
o Yes
o No

Private Funding

51

52

ALL

ALL

[If "Non-government funding" is selected in item 43 (types of funding sought)]
Did you seek funding or support for this I-Corps project from any of the following sources?
Self investment in the business entity
Bootstrap or crowd-funding 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
[If selected "Self investment in the business entity" in item 51 (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 (mm/yyyy)
 Description/Source (optional)

22

53

54

55

56

ALL

[If selected "Bootstrap or crowd-funding Bootstrap or crowd-funding" in item 51 (types of nongovernment funding sought)]
Please enter as much information as you can about your I-Corps project's bootstrap or crowdfunding activities.
 Amount
 Date received (mm/yyyy)
 Description/Source (optional)

ALL

[If selected "Individual private investment from non-accredited investor(s) (e.g., family, friends,
etc.)" in item 51 (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 (mm/yyyy)
 Description/Source (optional)

ALL

[If selected "Incubator or accelerator direct financing or equity exchange" in item 51 (types of
non-government 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 (mm/yyyy)
 Description/Source (optional)

ALL

[If selected "Debt financing (e.g., SBA loan or convertible debt instrument)" in item 51 (types of
non-government funding sought)]
Please enter as much information as you can about your I-Corps project's funding from debt
financing.
 Amount
 Date received (mm/yyyy)
 Description/Source (optional)

57

ALL

58

ALL

[If selected "Accredited angel investor or group" in item 51 (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 (mm/yyyy)
 Description/Source (optional)
[If selected "Non-corporate institutional venture capital/seed stage funding" in item 51 (types of
non-government funding sought)]
Please enter as much information as you can about your I-Corps project's funding from venture
capital and/or seed stage sources.
 Amount
 Date received (mm/yyyy)
 Description/Source (optional)

23

59

ALL

[If selected "Corporate venture capital/seed stage funding " in item 51 (types of non-government
funding sought)]
Please enter as much information as you can about your I-Corps project's funding from venture
capital and/or seed stage sources.
 Amount
 Date received (mm/yyyy)
 Description/Source (optional)
[If selected "Funding from foundations and non-profits" in item 51 (types of non-government
funding sought)]
Please enter as much information as you can about your I-Corps project's funding from venture
capital and/or seed stage sources.
 Amount
 Date received (mm/yyyy)
 Description/Source (optional)

60

Planned Funding

61

I-Corps

62

I-Corps

[If item 1 (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
[If "Federal government funding" is selected in item 61 (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)

24

63

64

I-Corps

[If "Federal government funding" is selected in item 61 (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

I-Corps

[If " Non-government funding" is selected in item 61 (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 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:

Incubator or Accelerator Support

65

66

ALL

I-Corps

[If item 1 (involvement with I-Corps project) response is "yes, I continued to be involved with the
project" AND Item 3 (whether project is active) response is "Yes"]
Has your [I-Corps] project participated in or received non-financial incubator or accelerator
support?
o Yes
o No
[If response to Item 65 (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 _________

25

67

68

69

70

ALL

[If response to Item 65 (non-financial incubator or accelerator support) is "yes"]
Please check the types of support your [I-Corps] project has received from incubators or
accelerators.
Physical office space
Wet labs/bench space
Training and/or mentorship
Access to investment network(s)
Other:

I-Corps

[If item 1 (involvement with I-Corps project) response is "yes, I continued to be involved with the
project" AND Item 3 (whether project is active) response is "No"]
Did your I-Corps project participate in or receive non-financial incubator or accelerator support?
o Yes
o No

I-Corps

[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 _________

I-Corps

[If response to item 69 (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:

Sales of new products, Services, or Processes

71

72

ALL

ALL

I-Corps

[If item 1 (involvement with I-Corps project) response is "yes, I continued to be involved with the
project"]
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
[participation in I-Corps/ NSF project]?
o Yes
o No
[If response to item 71 (commercialization) Is "Yes"]
Please enter the following information about products, services or processes.
 Describe Product
 Status
 Number of units sold (if any)
 Amount of sales in last fiscal year
 Amount of sales since commercialization

Regulatory Approval

[If response to company sector is "Healthcare/Medical" and company is active]
How many regulatory filings do you have for your I-Corps at NIH technology? Enter "0" if none.

26

[If response to # of regulatory filings is >0]
Select the options that best describe the regulatory approval process of the technology from your
I-Corps at NIH course.

I-Corps

I-Corps

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

Planned

Submitted

Approved

Rejected

Not applicable

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

Reimbursement Approval

I-Corps

I-Corps
I-Corps

[If response to # of regulatory filings is >0]
Select the options that best describe the reimbursement approval status of the technology you
worked on in the I-Corps at NIH course.
Horizontal scale: Planned, Submitted, Approved, Rejected, Not applicable
Centers for Medicare & Medicaid Services (CMS)
Private payer

Clinical Trials

[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 at NIH course had?
[If response to company sector is "Healthcare/Medical" and company is active]
Please check the boxes that best describe the status of clinical trials for the technology you
worked on in your I-Corps at NIH course.
Planned

Ongoing

Completed

Not applicable

Phase I clinical trial

27

Phase II clinical trial
Phase III clinical
trial
Premarket
approval (PMA)
device trial
Phase IV
Postmarketing
study
Outside of the
United States
(OUS)

I-Corps

[If response to company sector is "Healthcare/Medical" and company is active]
Please describe clinical trials you have conducted for the technology you worked on in your ICorps at NIH course.

Publications
I-Corps

I-Corps

["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 ICorps?
o Yes
o No

Licensing

[If item 1 (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?
o Yes
o No

74

ALL

75

ALL

[If response to item 74 (any licensing revenue generated) is "Yes"]
Please estimate the amount of licensing revenue generated from products, services or processes.
Numeric field

76

ALL

[If response to item 75 (licensing revenue amount) is >0]
Please estimate the percentage of total revenue gained from licensing.
Numeric Field

28

New Ventures

[If item 1 (involvement with I-Corps project) response is "yes, I continued to be involved with the
project" AND Item 3 (whether project is active) response is "Yes"]
I-Corps

Did your team's work on your I-Corps technology result in a spin-off or spin-offs?
Help text: A spin-off is when a company splits off a portion of itself to form a new company.
o
o

Yes
No

[If response to whether the team's work resulted in spin-offs is "yes"]
Please share some details on any spin-offs from your I-Corps technology below.
I-Corps

Name

Website

77

ALL

Are you currently pursuing a new venture?
o Yes
o No

78

I-Corps

[If response to item 77 (new venture) is "Yes"]
What is the name of this new venture?
Text box

I-Corps

[If response to item 77 (new venture) is "Yes"]
Are you using Osterwalder's Business Model Canvas in your new venture?
o Yes
o No

I-Corps

[If response to item 77 (new venture) is "Yes"]
Are you using the customer discovery process in your new venture?
o Yes
o No

79

80

Incorporation date

Spin-off 1
Spin-off 2
Spin-off 3
Spin-off 4

Other Outcomes

[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:
81

I-Corps

Course number: [TIME 1 RESPONSE]
Course title: [TIME 1 RESPONSE]
Course description: [TIME 1 RESPONSE]
Have you developed any additional entrepreneurial curricula?
o Yes
o No

29

ALL

[For all respondents with no Time 1 response to this question.]
[Since participating in the I-Corps course], have you developed any entrepreneurial curricula?
o Yes
o No

I-Corps

[If response to item 82 (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

84

ALL

Did the [I-Corps/ NSF] award lead to any collaborations between you and the external
community?
Industry
Investors
Local or state government
Non-profit organization
Other

85

ALL

[If response is "Yes "for "Other" in item 84 (individual collaborations)]
Please identify any other collaborations between you and the external community.

86

ALL

[If response is "Yes "for "Industry" in item 84 (individual collaborations)]
Please describe your industry collaboration(s).

ALL

[If response is "Yes "for "Industry" in item 82 (individual collaborations)]
What do you gain from your collaborations with industry?
o Opportunities to advance the commercialization of your research
o Opportunities to advance your research agenda
o Neither of the above

ALL

Did the [I-Corps/NSF] award lead to any collaborations between the university you are currently
affiliated with and the external community?
o Yes
o No
o I am no longer affiliated with a university

ALL

[If response is "Yes" for item 86 (university collaborations)]
Which of the following collaborations between the university you are currently affiliated with and
the external community did the [I-Corps/ NSF] award lead to?
o Industry
o Investors
o Local or state government
o Non-profit organization
o Other

82

83

87

88

89

30

90

ALL

[If response is "Yes" for "Other" in item 89 (types of university collaborations)]
Please identify any other collaborations between your university and the external community.

Opportunities

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
o Customer interviews
o Instructor engagements
o Interactions with your team's EL(s) or PI(s)
o Interactions with your team's mentor(s)
o Interactions with other teams' ELs or PIs
o Interactions with other teams' mentors
o Other interactions

91

I-Corps

92

I-Corps

Please describe:

93

I-Corps

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

94

I-Corps

Please describe:

Current Employment
95

96

I-Corps

I-Corps

Do you currently work for a college or university?
o Yes
o No
o Not currently employed
[If response to item 95 (whether currently working for college or university) is "Yes"]
Do you currently work for [PERSONAL INSTITUTION AT REGISTRATION]?
o Yes, I am primarily employed at a college or university.
o Yes, I work at a college or university as well as a private company.
o No, I work outside of academia.
o No, I am not currently employed.

31

I-Corps

[If response to item 95 (whether currently working for college or university) is "Yes, I am primarily
employed at a college or university" or "Yes, I work at a college or university as well as a private
company."]
Which of the following best describes your current role? Multiple choice.
o Tenured faculty member
o Faculty member on track for Tenure and Promotion
o Non-tenured Faculty
o Non-traditional university appointment (e.g., Professor of Practice, Visiting Scholar, etc.)
o Research scientist
o University Leader (Dean, Provost, etc.)
o Administrative Staff (Academic Advisor, Center Director, etc.)
o Student
o Other:

I-Corps

[If response to item 95 (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?
o Agriculture
o Education
o Energy & Materials
o Environment
o Healthcare/Medical
o Information Technology and Communications
o Infrastructure/Building
o Sanitation/Water
o Not applicable
o Other

I-Corps

[If response to item 95 (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?
o 1-10 employees
o 11-50 employees
o 51-200 employees
o 201-500 employees
o 501-1000 employees
o More than 1000 employees
o Other

100

I-Corps

[If response to item 95 (whether currently working for college or university) is "Yes, I am primarily
employed at a college or university." Or "Yes, I work at a college or university as well as a private
company." or "No, I work outside of academia."]
Did your work in I-Corps lead to your current employment?
o Yes
o No
o Unsure

101

I-Corps

[If response to item 100 (work in I-Corps leading to current employment) is "Yes" or "Unsure"]
Please explain:

97

98

99

32

102

I-Corps

[If response to item 95 (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
103

I-Corps

Have you participated in another national I-Corps team in addition to [TEAM NAME]?
o Yes
o No

104

I-Corps

[If response to item 103 (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)
Which course(s) attended

105

I-Corps

[If response to item 103 (other national team participation) is "Yes"]
Did the team(s) raise any government funding? Please describe, including funding type (SBIR,
PFI:AIR TT, etc.)

106

I-Corps

[If response to item 103 (other national team participation) is "Yes"]
Did the team(s) raise any private funding? Please describe.

107

ALL

Anything Else

Thanks for your responses! Is there anything else you would like us to know about your [I-Corps/
commercialization] experience that wasn't captured by this survey?

Demographics
ALL

ALL

What is your current gender identity?
o Male
o Female
o Another identity
o 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.

ALL

What is your race? (Select one or more) American Indian or Alaska Native
o Asian
o Black or African American
o Native Hawaiian or Other Pacific Islander
o White
o Other
o Prefer not to answer

ALL

Are you of Hispanic, Latino, or Spanish origin?
o Yes
o No
o Prefer not to answer

33

ALL

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.

ALL

Have you ever served on active duty in the U.S. Armed Forces, Reserves, or National Guard?
o Never served in the military
o Only on active duty for training in the Reserves or National Guard
o Now on active duty
o On active duty in the past, but not now
o Prefer not to answer

ALL

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

34