Non-I-Corps PI Survey Instrument

Appendix C: Non-I-Corps PI Survey Instrument

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Count

NSF Award Commercialization History (Survey Screener)

1

Have you ever received an I-Corps Team award from the National Science Foundation (NSF)?
o Yes [Exit Survey]
o No

2

Have you ever received an I-Corps at NIH award from the National Institutes of Health (NIH)?
o Yes [Exit Survey]
o No

3

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.
2.
3.
4.
5.

Project Title A
Project Title B
Project Title C
Project Title D
Other (please specify)

Award Number
Award Number
Award Number
Award Number
Award Number

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

(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.a.

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

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

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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

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

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

7

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

8

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 I-Corps Site or Node programs
•
Never
but not associated with an I-Corps Team’s award)
•
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
Courses using Customer Discovery or the Business Model Canvas
•
Never
•
Less than 1 day
•
At least 1 day but less
than 1 week

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•
•
•

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

•
•
•
•
•
•
•

Other entrepreneurial educational programs. Please specify.

•
•
•
•
•
•
•
•

9

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

10

Are you familiar with the Osterwalder Business Canvas Model?
o Yes
o No

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
Never
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
Never
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

Status of the Commercialization Effort
11

Is this commercialization effort still active?
o Yes [go to item 13]
o No
o Uncertain [go to item 14]

12

[If “No” to item 11]
In what year would you say that your efforts to commercialize the NSF project research stopped?
YYYY [go to item 12]

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13

14

[If “Yes” to item 11]
How involved are you in the commercialization effort?
o Very involved
o Involved
o Somewhat involved
o 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.
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 (specify)

15

[If item 11 (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 (Specify)

16

Which of the following best describes your NSF project's main 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 Internet of Things (I)
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
Your Team

17

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?
o
o

Yes
No [go to item 21]

17.a

Since you began exploring the commercial opportunities associated with your NSF project, how many team members
have you worked closely with?
[type number]

18

When the team collaboration began, were any of the members of your team:

57

[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
19

Did any of these team members have prior entrepreneurial background?
o Yes
o No

20

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 (please specify)
Business creation

21

Has a company been incorporated based on your NSF project?
o Yes [go to item 23]
o No

22

[If no in item 21]
Did you previously incorporate a company that you used to or could use to commercialize your NSF project
research?
o Yes
o No [go to 38]
[if yes to 21 or 22] 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

23

24

[if yes to item 21 or 22] What is the URL of the company's website, if any?

25

[if yes to item 21 or 22] When was the company incorporated? (mm/dd/yyyy)

26

[if yes to item 21 or 22] Is this company still in operation?
o Yes
o No
[ if yes to item 21 or 22] What sector best describes this company?
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 (Specify)
[If response to item 26 (whether company is operational) is "No"]
Approximately when did this company close or dissolve?
(mm/yyyy)

27

28

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29

[If response to item 26 (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]

30

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.

31

["If response to item 26 (whether company is active) is "yes"]
Please select the items below that are true of your business.
majority owner(s),
co-owner(s),
in leadership role(s)
Women are …
□
□
□
Socially disadvantaged
□
□
□
individuals are …
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."

32

["If response to item 26 (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.
Licensing or Other Business Arrangements

33

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) ________

34

B. Since you started the commercialization efforts related to your NSF project, how many of the following has the
business licensed?*** Enter "0" if none.

59

Licensed OUT**

Licensed IN***

Patents
Copyrights
Trademarks
Trade Secrets
** Licensing out is licensing patents, copyrights, or trademarks owned by the business to other parties under a
licensing agreement.
*** 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.
Government funding
35

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

36
[If checked government funding]
Did you apply for government funding from any of the following agencies? (Check all that apply)
Yes
□

No
□

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

□

□

National Science Foundation

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37

Did you receive government funding from any of the following agencies? (Check all that apply)
Yes
□

No
□

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

□

□

National Science Foundation

38

39

State and Regional Funding
[If "State or regional government funding" is selected in item 35 (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.)

Rregional funding, if applicable

Description of award
[If "State or regional government funding" is selected in item 35 (types of funding sought)]
Have you received any additional government funding not covered under Federal funding or State/regional funding
above:
o Yes
o No
Please explain:
Private Funding

40

[If "Non-government funding" is selected in item 35 (types of funding sought)]
Did you seek funding or support for this NSF project from any of the following non-government 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.)

61

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
41

Has your NSF project participated in or received non-financial incubator or accelerator support?
•
Yes
•
No

42

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):

Sales of new products, Services, or Processes
43

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 project?
o Yes
o No

44

[If response to item 42 (commercialization) Is "Yes"]
Please enter the following information about products, services or processes.
•
Describe Product
•
Status

45

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

46

Since the start of your commercialization effort, have you developed any entrepreneurial curricula?
o Yes
o No

47

Did your NSF project lead to any collaborations between you and…?
Yes
Industry?
□
Investors?
□
Local or state government?
□
Non-profit organization?
□
Other?(Specify)
□

48

No
□
□
□
□
□

[If response is "Yes "for "Industry" in item 46 (individual collaborations)]
Please describe your industry collaboration(s).

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49

[If response is "Yes "for "Industry" in item 46 (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
o Other (specify)

50

Did your NSF project 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
[If response is "Yes" for item 50 (university collaborations)]
Which of the following collaborations between the university you are currently affiliated with and the external
community did the NSF award lead to?
Yes
Uncertain
No
Industry
○
○
○
Investors
○
○
○
Local or State
○
○
○
Government
Non-profit organization
○
○
○
Other (Specify)
○
○
○
Current Employment

51

52

Do you currently work for a college or university?
o Yes
o No [go to demographics]
o Not currently employed [go to demographics]

53

Do you currently work for…
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.

54

[If response is “Yes” in item 53]
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 (specify):

55

[If response is “No, I work outside of academia.“ in item 53]
Did your work with commercializing your research lead to your current employment?
o Yes
o No
o Unsure

63

Demographics
56

57

58

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.
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

59

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

60

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.

61

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

62

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

63

Yes

No

Prefer not to
answer

○
○
○
○

○
○
○
○

○
○
○
○

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

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