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pdfOffice of Veterans Business Development
Boots to Business Entrepreneurship Survey for Service members and Military Families
Consent Form
Use of information: This information collection (survey) is to be completed by individuals who have participated in
the Boots to Business courses offered by the Small Business Administration (SBA). Disclosure of the information
requested on this form is voluntary as participants may exit the survey at any time or skip questions they prefer
not to answer. This study is being conducted by researchers at the Institute for Veterans and Military Families
(IVMF) in conjunction with the U.S. Small Business’s Office of Veteran Business Development (OVBD) to gather
information from military service members and families about their experiences in our B2B entrepreneurship
program and about their entrepreneurship motivations, barriers and goals. We are collecting this information to
improve our program offerings as well as to understand entrepreneurship experiences and outcomes. All
information provided is protected to the extent permitted by law, including the Privacy Act of 1974, 5 U.S.C. 552a
and the Freedom of Information Act (FOIA), 5 U.S.C. 552. SBA maintains your personal information in the agency’s
Privacy Act Systems of Records, SBA 5-- Business and Community Initiatives Resource Files. This system of record
notice (SORN) identifies why and to whom SBA will routinely disclose the information that you provide.
In addition to those routine uses, please select Agree or Do Not Agree below to indicate whether you authorize
SBA or its agent to also use your name and contact information for SBA surveys and information mailings regarding
SBA products and services as part of the Boots to Business alumni network. SBA will not provide your personal
information to commercial entities. Choose an item.
Please note: Under the Paperwork Reduction Act you are not required to respond to any collection of information
unless it displays a currently valid OMB Control number. This collection has been assigned OMB Control number
3245-0390. The estimated time for completing this survey is 10 minutes, including gathering and submitting the
information. Comments on the estimated time, including suggestions for reducing the time, should be sent to
Boots to Business Program Manager: U.S. Small Business Administration, Office of Veterans Business Development,
409 3rd Street SW Suite 5700, Washington, DC 20416, and to: SBA Desk Officer, Office of Management and
Budget, New Executive Office Building, Room 10202, Washington, D.C., 20503.
Available Sources of Information: If you have questions about this study, please contact the Boots to Business
help desk at (202) 205-8381, email: [email protected]. If you have concerns or complaints about your
rights as a participant, please contact the Boots to Business help desk at (202) 205-8381.
AUTHORIZATION: Clicking on the “Agree” option below indicates that:
• You have read the above information.
• You voluntarily agree to participate.
• You are at least 18 years of age.
☐ Agree
☐ Do Not Agree –> EXIT SURVEY
OMB Control #: 3245 - 0390
Expiration Date: 05/31/2022
Quality Assessment Post Course Survey
Instructions: Please answer the following questions. Some questions will require you to write your answers, while
others will require you to select your answers. The information we collect from this evaluation will be kept
confidential. Your feedback is important for us to understand the impact of the Boots to Business program.
1.
Name: Click here to enter text.
2.
Email Address: Click here to enter text.
3.
Course date completed: (mm/dd/yyyy)
Please enter the date of the most recent course you completed. If you don’t know the date you completed
your most recent course, please provide a best estimate.
Click here to enter a date.
4.
Please select the course you most recently completed:
☐ Boots to Business
☐ Reboot
☐ Revenue Readiness
5.
Please choose the state or territory where you most recently took your course: Click here to enter text.
6.
Please choose the installation where you most recently completed your course: Click here to enter text.
7.
Service:
☐Air Force
☐Air Force Reserve
☐Air National Guard
☐Army
☐Army Reserve
☐Army National Guard
☐Coast Guard
☐Coast Guard Reserve
☐Marine Corps
☐Marine Corps Reserve
☐Navy
☐Navy Reserve
8.
Age Range:
☐< 25
☐25 - 35
☐36 - 49
☐> 50
9.
Gender:
☐Male
☐Female
☐Not Stated
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SBA Form #:
Date:
OMB Control #: 3245 - 0390
Expiration Date: 05/31/2022
10. Ethnicity:
☐Hispanic or Latino
☐Not Hispanic or Latino
☐Not Stated
11. Race:
☐American Indian
☐Alaska Native
☐Asian
☐Black or African American
☐Native Hawaiian or Pacific Islander
☐White or Caucasian
☐Not Stated
12. Please select the status that best describes you at the time you completed the course – if you are a service
member who is married, please select your status and Dual Military Spouse:
☐Dependent spouse
☐Other dependent
☐Veteran
☐Service member
☐Dual military spouse
☐Service disabled veteran
☐Transitioning/retiring service member
The following questions refer to pre-course coordination, specifically concerning the coordination and information
you received from the Boots to Business team concerning your books, course and other administrative issues
relating to the course:
13. Describe the level of communications you received about the course prior to attending:
☐Way too much communication
☐Too much communication
☐About right
☐Too little communication
☐Way too little communication
14. Please rate how satisfied you are with all course materials:
☐Very Satisfied
☐Satisfied
☐Neutral
☐Dissatisfied
☐Very Dissatisfied
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SBA Form #:
Date:
OMB Control #: 3245 - 0390
Expiration Date: 05/31/2022
15. Instructor(s):
Please rate your satisfaction with
your instructor(s) in the following
areas:
Classroom was conducive to a
learning environment
Very
Dissatisfied
Dissatisfied
Neutral
Satisfied
Very
Satisfied
N/A
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Displayed knowledge and familiarity
with B2B course material
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Exhibited presentation skills that
engaged the class
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Used training aids and materials to
instruct course material
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Communicated clearly and
effectively
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Integrated practical experience and
participants’ ideas into the course
material
16. Regarding the course overall, please select the most appropriate response to the items below.
Way too
little
Too Little
About
Right
Too
Much
Way too
much
Amount of material covered
☐
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Depth of coverage
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Mix of topics
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17. Please briefly describe what course content you would like to see added or subtracted from the course or any
specific module. Click here to enter text.
18. Pace of coverage:
☐Way too fast
☐Too fast
☐About right
☐Too slow
☐Way too slow
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SBA Form #:
Date:
OMB Control #: 3245 - 0390
Expiration Date: 05/31/2022
Regarding the Revenue Readiness course, please select the most appropriate response to the items below. Please
read each response carefully! (Note: Only Revenue Readiness participants will respond to this question)
Strongly
Disagree
Disagree
Neither
Agree
Strongly
Agree
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The online registration was easy to navigate.
Technical support was readily available.
The course website was well organized.
Navigating through the courses was easy.
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SBA Form #:
Date:
OMB Control #: 3245 - 0390
Expiration Date: 05/31/2022
19. Please answer the following questions about how you felt before and after attending the course:
Before
After
Not at
all
Not
very
Neither
Somewhat
Very
Not at
all
Not
very
Neither
Somewhat
Very
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How motivated were you to
start a business?
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How likely were you to start a
business?
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How likely were you to start a
business later (5-10 years)?
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How likely were you to pursue
higher education first?
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How likely were you to pursue
employment first?
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How informed did you feel
about starting a business and
entrepreneurship in general?
How confident were you about
having the skillsets required to
start a business?
How likely were you to start a
business soon (within one
year)?
How likely were you to start a
business soon (within one
year)?
How likely were you to pursue
technical assistance (counseling
and/or training related to
starting or growing a business financing, contracting, business
planning, marketing, etc.)?
20. Other than the information covered already, do you have any additional input regarding the course? Click here
to enter text.
6
SBA Form #:
Date:
OMB Control #: 3245 - 0390
Expiration Date: 05/31/2022
21. Which of the following best describes your interest in starting or owning a business now that you have
completed the course:
☐I am significantly more interested in starting or owning a business
☐I am more interested in starting or owning a business
☐I am neither more nor less interested in starting or owning a business
☐I am less interested in starting or owning a business
☐I am significantly less interested in starting or owning a business
22. Did the course increase your confidence in starting or owning a business?
☐Yes
☐No
23. Would you refer someone to the course?
☐Yes
☐No
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SBA Form #:
Date:
| File Type | application/pdf |
| File Modified | 2022-02-22 |
| File Created | 2022-02-22 |