RIC OMB ICR - Appendix B-5 Small Business Survey
OMB Approval number: 3245-0392
Expiration Date: 04/30/2026
Small Business Survey
Contact Information
Enter your First Name (Required)
Enter your Last Name (Required)
Enter your Job Title (Required)
Enter your Email Address (Required)
Enter your Business Name (Required)
Enter your Business Zip Code (Required)
Since October of [last year], did you participate (either in person or virtually) in any business training, technical assistance services, and/or matchmaking, networking, or showcasing events or activities in general?
Yes
No
Don’t know
This survey asks questions about your experience with [cluster name] ([cluster acronym]) (also known as [alternative_cluster_names]) - an implementer of the Regional Innovation Cluster Initiative.
[If yes to Q2, proceed to Q3]
[If no or don’t know to Q2, proceed to statement below then Q5-Q6 and then Q30]
[If yes to Q2] Did you participate (either in person or virtually) in any group business training and/or matchmaking, networking, or showcasing events or activities organized by or connected with {cluster name}?
Yes
No
Don’t know
[If yes to Q2] Did you participate in one-on-one (either in person or virtually) counseling, mentoring, or technical assistance services or activities organized by or connected with {cluster name}?
Yes
No
Don’t know
[If yes to Q3 OR Q4, proceed to Q7 and the full survey]
[If no or don’t know to Q2 or to both Q3 and Q4, proceed to statement below then Q5-Q6 and then Q30]
Based
on the administrative records from {cluster
name},
you took part in or registered in business trainings, technical
assistance services and/or matchmaking, networking, or showcasing
events or activities organized by or connected with {cluster
name}.
If you are unsure, unaware, or don’t recall your attendance in
these events or services, we would still like to ask you a few
questions that may help {cluster
name}
and organizations with similar functions to tailor their outreach to
businesses like yours. We greatly appreciate your time and
cooperation.
What are the reasons you responded “No” or “Don’t know” above? (Select all that apply.)
Do not have direct ties with {cluster name} or its network
Do not expect to receive any benefits from cluster participation
Do not have the time to participate
I sold or closed my business
Do not remember or did not know it was a “cluster” event or activity
Other, please specify:
What can {cluster name} or an organization with similar functions offer you or your business to improve your engagement with its activities, services, and/or business network?
[text box]
To gather information on the types of firms that are not engaging with the {cluster name} or are unaware of {cluster name} services, we would like to ask you a few questions that may help clusters tailor their message and outreach to businesses like yours.
[Skip to Q30, Business Characteristics page. ]
The next questions ask about the involvement of your business in the cluster.
Please provide the month and year in which your business began attending events or activities or began receiving services organized by or connected with {cluster name}:
Month: MM
Year: YYYY
Don’t recall
Why did your business attend or participate in {cluster name}-organized counseling, training, mentoring, other technical assistance, or outreach events? (Select all that apply.)
To access {cluster name} services (e.g., counseling, trainings, events)
To access new exporting opportunities
To network with other small businesses, large businesses, and/or potential clients
To access government procurement opportunities
To access new business capital, financing
To access SBIR/STTR grants or contracts
To improve innovation (e.g., develop new products or services)
Other, please specify:
[If Q3=Yes] Since October of [last year], how many times did your business attend (either in person or virtually) {cluster name}-organized or sponsored trainings, and/or matchmaking, networking, or showcasing events or activities since October of [last year]?
[numeric box]
[If Q4=Yes] Since October of [last year], how many times did your business participate (either in person or virtually) in {cluster name}-organized or sponsored one-on-one counseling, mentoring, or technical assistance services since October of [last year]?
[numeric box]
Could you have received the same services or joined in comparable events elsewhere as those provided or organized by {cluster name} (e.g., Small Business Development Centers [SBDCs], chamber of commerce)?
Yes
No
Don't know
Since October of [last year], did your business participate in other business-support programs or organizations that are not affiliated with {cluster name} (e.g., SBDCs, chamber of commerce)?
Yes
No
Don’t know
[If no or don’t know to Q12, proceed to Q14]
(If Q12= Yes) Which of these business-support programs or organizations did your business participate in? (Select all that apply.)
SBA programs (e.g., 7(j), 8(a), T.H.R.I.V.E. Emerging Leaders)
Small Business Development Centers
SCORE Association
Women’s Business Centers
Veteran’s Business Outreach Centers
U.S. Export Assistance Center
Apex Accelerators or Procurement Technical Assistance Centers
Business, industry, or professional organizations or associations
Chamber of Commerce
Federal programs
State or local government programs
Other, please specify:
(If Q3=Yes) How satisfied are you with the group trainings or matchmaking, networking, and/or showcasing events or activities provided or organized by {cluster name}?
Very dissatisfied
Dissatisfied
Unsure
Satisfied
Very satisfied
(If Q4=Yes) How satisfied are you with the one-on-one services (counseling, mentoring, or technical assistance) provided or organized by {cluster name}?
Very dissatisfied
Dissatisfied
Unsure
Satisfied
Very satisfied
The next questions focus on the extent to which cluster activities and cluster staff help advance equity among small underserved businesses within the ecosystem. The intent is to measure how the cluster tailors its approach to better support underserved small businesses and their owners.
To what extent do you agree or disagree with these statements about the [cluster name] sponsored events, activities, and trainings, and the staff that conducted these services? Please feel free to leave the row blank if you are not comfortable providing a response. Select “Not Applicable” if an activity was not relevant for you.
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Strongly Disagree |
Disagree |
Neither |
Agree |
Strongly Agree |
Not Applicable |
I trust the staff |
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The staff asked for feedback and incorporated ideas into services, events, and activities |
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The staff is comprised of people with diverse races, ethnicities, and backgrounds |
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The staff were respectful of people with diverse races, ethnicities, and backgrounds |
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The staff have been responsive to needs and circumstances of people with diverse races, ethnicities, and backgrounds |
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The staff were knowledgeable about people of different races, ethnicities, and backgrounds |
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There are virtual activities and services available |
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Activities and services are located in or close to the neighborhood where I live |
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Accommodations were provided for people with disabilities (e.g. closed captions, ASL and other language interpretation, elevators, ramps) |
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Documents, materials, or services were available in multiple languages |
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To what extent did your participation in the {cluster-name} help your business achieve any of these benefits?
Cluster - related activities helped my business: |
Too early to tell |
Not at all |
A little |
Somewhat |
Much |
Very much |
N/A |
Increase revenue |
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Increase and/or retain jobs |
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Stay in business |
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Start/open a new business |
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Improve business management processes and operations |
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Export products and/or services |
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Develop or improve collaboration or relationships with other businesses or organizations |
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Improve participation in industry supply chain |
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Other, please specify: |
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Since October of [last year], has your participation in the {cluster name} helped your business establish any new business relationships (e.g., buying/selling goods/services, project collaboration, joint ventures)?
Yes
No
Don’t know
(If Q18=Yes) Has your participation in the {cluster name} helped your business establish any new relationships with these types of organizations or resources in your community or region?
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How many relationships were formed? |
SBA programs or loans |
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SBA resource partners (WBC, VBOC, SCORE, etc.) |
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Other Federal Government agencies |
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State or local government agencies |
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Foundations, nonprofits, and nongovernment organizations |
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Business organizations, associations, and chambers of commerce |
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Large firms, corporations, and companies |
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Innovation-driven enterprises (growing firms and startups focused on innovation) |
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Financing sources (banks, venture capital, etc.) |
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Universities |
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Community colleges |
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Research centers and institutes |
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Business incubators and accelerators |
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Local community organizations |
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Other, specify |
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(For the endorsed items in Q19) How helpful were these new relationships for your business’s operations and/or growth?
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Too early to tell |
Not at all |
A little |
Somewhat |
Much |
Very much |
SBA programs or loans |
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SBA resource partners (WBC, VBOC, SCORE, etc.) |
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Other Federal Government agencies |
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State or local government agencies |
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Foundations, nonprofits, and nongovernment organizations |
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Business organizations, associations, and chambers of commerce |
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Large firms, corporations, and companies |
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Innovation-driven enterprises (growing firms and startups focused on innovation) |
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Financing sources (banks, venture capital, etc.) |
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Universities |
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Community colleges |
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Research centers and institutes |
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Business incubators and accelerators |
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Local community organizations |
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Other |
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This section asks for your experiences conducting or supporting various types of innovation, and the cluster's help in supporting your innovation efforts.
Did your business conduct any innovation during your participation in the cluster? (Select all that apply.)
Product and service innovation: new product or improvements in performance of the product or service
Process innovation: the implementation of a new or improved production or delivery method
Technological innovation: new or improved technology or incorporating technology into a production process
Business model innovation: change in business operations to develop or deliver innovation
Indirect innovation: for example, funding, networking, influencing legislation, or other activities indirectly supporting innovation
None of the above
[If a, b, c, or d are selected in Q21] How many of these innovation outcomes did your business achieve?
New products or services developed: _________
Trademarks or brand registrations obtained: _________
Technologies licensed to others: _________
Technologies obtained licensing rights to: ________
Patents filed: ________
Patents awarded: __________
Other, specify: ____________
[ If a b, c, or d are selected in Q21] To what extent did {cluster-name} or {cluster-name}-organized trainings, events (including networking events), activities, and/or services help your business achieve innovation?
Too early to tell
Not at all
A little
Somewhat
Much
Very much
Since October of [last year], did your business obtain new financing (e.g., loan, capital, grants)?
Yes
No
Don’t know
[If Q24=Yes] For each of these sources of financing, please provide the number of instances and the total dollar amount obtained by your business. If you do not have exact values, please give your best estimate for each type.
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Number of instances obtained |
Total amount obtained |
SBA loans (e.g., 7(a), CDC/504, EIDL, PPP) |
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NonSBA loans |
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Venture or angel capital |
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SBIR or STTR grants or contracts |
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Other grants (not SBIR/STTR) |
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Line of credit (excluding credit cards) |
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Other forms of financing (e.g., friends and family, crowdfunding) |
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[If Q24=Yes] To what extent did your participation in the {cluster name} help your business obtain any new financing?
Too early to tell
Not at all
A little
Somewhat
Much
Very much
Since October of [last year], was your business awarded any new prime contracts with, or subcontracts connected with, a government, corporate, or nonprofit entity?
Yes
No
Don’t know
[If Q27=Yes] For each of these entities, please provide the number of contracts or subcontracts and the total value obtained by your business. If you do not have exact values, please give your best estimate for each type.
Entity |
Number of contracts or subcontracts |
Value of contracts or subcontracts (dollars) |
Government (federal, state, or local) |
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Corporate |
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Nonprofit (hospitals, academic institutions, or other organizations) |
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Other, please specify: |
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[If Q27=Yes] To what extent did your participation in the {cluster name} help your business receive any award of contracts or subcontracts?
Too early to tell
Not at all
A little
Somewhat
Much
Very
much
Please indicate the year when your business was first established:
Year: YYYY
Is your business registered in the System for Award Management (SAM)?
Yes
No
Don't know
(If Q31=Yes) What is your business’s SAM.GOV Unique Entity Identifier (UEI)?
The business’s UEI would allow the SBA to conduct an analysis of businesses’ contracts over time. We will keep your UEI strictly confidential and securely stored.
<Text box >
Don’t know
Don’t want to report
[If Q32=blank, don’t know, or don’t want to report] What’s the industry of your business? (Based on two-digit NAICS code.) [pulldown menu]
11 Agriculture, Forestry, Fishing, and Hunting
21 Mining
22 Utilities
23 Construction
31-33 Manufacturing
42 Wholesale Trade
44-45 Retail Trade
48-49 Transportation and Warehousing
51 Information
52 Finance and Insurance
53 Real Estate Rental and Leasing
54 Professional, Scientific, and Technical Services
55 Management of Companies and Enterprises
56 Administrative and Support and Waste Management and Remediation Services
61 Educational Services
62 Health Care and Social Assistance
71 Arts, Entertainment, and Recreation
72 Accommodation and Food Services
81 Other Services (except Public Administration)
99 Other, please specify:
[If Q32=blank, don’t know, or don’t want to report] Does your business currently hold any official (not self-reported) certifications (e.g., Women-Owned, 8(a), Minority-Owned)?
Yes
No
Don’t know
[If no or don’t know to Q34, proceed to Q36.]
(If Q34=Yes) Does your business currently hold any of these officially designated certifications? (Select all that apply.)
SBA-certified 8(a) Business
SBA-certified HUBZone Business
SBA-certified Small Disadvantaged Business
SBA-certified Women-Owned Small Business or Economically Disadvantaged Women-Owned Small Business
Certified Minority-Owned Business
Certified Service-Disabled Veteran-Owned Business or Veteran-Owned Business
Socially and Economically Disadvantaged Business
Other certificates, please specify:
Does the business owner(s) have any of these characteristics? (Select all that apply.)
Racial/ethnic minority owner(s)
Hispanic or Latino
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or Other Pacific Islander
Other
Veteran owner(s)
Women owner(s)
Disabled owner(s)
Immigrant owner(s)
LGBTQ+ owner(s)
Other, specify:
The following questions about your business and business growth are sensitive and you could leave them blank if you are not comfortable reporting them. However, these questions are important for the SBA to evaluate the RIC Initiative’s performance in assisting small businesses.
Please provide an estimate of the percent change in your business’s revenue for these time periods:
Since the year prior to your RIC Initiative participation: [pull-down or slide menu from -100% to 0% to + 500%]
(If Q7 < [this year]) Since October of [last year]: [pull-down or slide menu from -100% to 0% to +500%]
Please provide an estimate of the percent change in the number of your business’s employees (including full-time and paid owner(s)) for these time periods:
Since the year prior to your RIC Initiative participation: [pull-down or slide menu from -100% to 0% to + 500%]
(If Q7 < [this year]) Since October of [last year]: [pull-down menu or slide from -100% to 0% to +500%]
[If Q3 OR Q4=Yes] Please provide suggestions for improving the trainings, events, activities, or services, including networking provided or organized by {cluster name}: ___________
Are you willing to be contacted in the future regarding a brief virtual interview as part of this evaluation?
Yes
No
Don’t know
Thank you for participating in this survey.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Nicholas Bahel |
| File Modified | 0000-00-00 |
| File Created | 2024-07-20 |