G402 WE Post-Mentoring Program Survey Questions Final

OMB Control No.: 0651-0080

Expiration Date: ##/##/####

Women’s Entrepreneurship (WE) Post-Mentoring Program Survey

Please provide the following information:

1. Full Name (will not be shared publicly without consent)

2. Preferred E-mail Address (will not be shared publicly without consent)

3. Preferred Phone Number (will not be shared publicly)

4. Location (state)

5. What goal(s) did you want to accomplish by participating in this program?

6. How did you find out about this mentoring program? (drop down from the following options)

   1. At a USPTO event or workshop

   2. From a social media post

   3. Through another mentorship program or development program.

   4. From a colleague or friend.

   5. Through an internal communication at my organization.

   6. From a USPTO or IPO email invitation.

   7. From the USPTO or IPO website.

   8. From a friend or colleague.

7. What method of communication would work best to follow up with you? (Phone call, text, video chat, email, other)

8. Please rate your satisfaction with the following items (Radial Buttons: 1-Completely Unsatisfied, 5 – Completely Satisfied)

   1. The frequency of communication between you and your mentor

   2. The length of the mentoring program

   3. The topics discussed between you and your mentor

   4. This program helped you towards accomplishing your goals

   5. If applicable, how easy it was to communicate any issues with the program contacts

   6. How easy it was to sign up for the mentoring program

8. On a scale of 1-10 (1-not at all, 10-definitely), would you recommend this mentoring program to others?

A Federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with an information collection subject to the requirements of the Paperwork Reduction Act of 1995, unless the information collection has a valid OMB Control Number. The OMB Control Number for this information collection is 0651-0080. Public burden for this survey is estimated to average 8 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the information collection. Send comments regarding this burden estimate or any other aspect of this information collection, including suggestions for reducing this burden to the Office of the Chief Administrative Officer, United States Patent and Trademark Office, P.O. Box 1450, Alexandria, VA 22313-1450 or email [email protected].