3245-0392 Appendix D-2 Cluster Administrator Consent Form 2-23-2023

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Appendix D-2 Cluster Administrator Consent Form

Dear [Cluster Administrator name],

The U.S. Small Business Administration (SBA), via the Regional Innovation Clusters (RIC) Initiative, is investing in regional clusters throughout the United States that span a variety of industries. The SBA has hired a small business research organization Optimal Solutions Group, LLC (Optimal) to conduct the evaluation of the RIC. The objective of this evaluation is to determine if the RIC Initiative is meeting its intended business growth outcomes. The results are expected to provide suggestions for improvements to this valuable small business assistance program.

The research team will be conducting a brief web survey and an individual webinar interview with all RIC Administrators that have participated in RIC-funded activities or services in [year]. The primary purpose of these data collections is to gather information on the implementation of clusters’ activities, evolution of the clusters’ structure and operations, and best practices. The interview will clarify and follow up on the content of the progress reports to gather information on the implementation of cluster activities, challenges, mitigations, and best practices. The interview will also obtain information about how the operations have evolved, the adjustments made, and the lessons learned during the year.

Your participation in these data collections is voluntary; however, failure to respond may be a violation of the terms and conditions of your contract with SBA. The interview is expected to take no more than 60 minutes to complete, and the web survey will take less than 15 minutes.

Confidentiality and Usage

Your responses to the interview and survey will be kept strictly confidential, and your name will never be used in any reports produced for this evaluation. All survey responses will be presented as aggregated statistics in the form of averages, percentages, and frequency counts. Any quotations or information from the interviews may be included in the public report without identifying the respondent, through such phrases as “an administrator of a cluster noted that…”

Optimal Solutions Group LLC will collect and store your responses to this survey on a secure server accessible to Optimal Solutions Group staff only. Any information provided in this survey will be kept confidential. No respondent will be identified or named in any publicly available report or other such publication. All survey responses will be presented as aggregated statistics in the form of averages, percentages, and frequency counts. All survey responses will be de-identified and then these data will be provided to the SBA.

• If you have questions about the program, please contact Philip Gibson, (202)205-7427, [email protected].

• If you have questions about your participation in this study, please contact Oswaldo Urdapilleta at Optimal, (301) 306-1170 Ext. 709, [email protected]

• If you have any questions or experience technical difficulties accessing or submitting the survey, please contact us at [email protected] or toll free at 1-800-970-2487.

Your signature on this form grants the research team permission to conduct the web survey and interview as described above. The research team will not use the information provided for any reasons other than those stated in this consent form without your permission. If you understand and accept these conditions, please sign and date below.

Thank you in advance for your assistance.

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