Beyond Jobs Program Interest Survey
Birthday
Full Name
Phone Number
Email
Thank you for your interest in Beyond Jobs! Please take a moment to answer these questions to help us understand your needs better. Consider the information you have been provided when making your decision about committing to our program.
EDUCATION & CREDENTIALS
Highest level of education completed:
Some High School
High School Diploma
GED / HiSET
Some College / Community College
Completed College
Other
Please specify:
Are you currently enrolled in school?
Yes
No
If yes, where?
EMPLOYMENT STATUS & WORK HISTORY
Are you currently employed?
Yes
No
How long have you been unemployed?
Less than 3 months
3–6 months
More than 6 months
Current Job Details
Employer:
Length of employment:
Less than 6 months
6 - 12 months
1 year - 2 years
2 years +
Total work experience:
Less than 1 year
1–2 years
3+ years
Do you have a resume?
Yes
No
Resume status:
Current (updated within last 6 months)
Needs updating
EMPLOYMENT GOALS & READINESS
What is your primary goal right now?
Check one.
Find a job as quickly as possible
Improving skills and job readiness before employment
Explore training or education options
Obtain my GED/HiSET
Accessing resources for my current situation (e.g. transportation, housing, etc.)
Not sure yet
What type of work are you interested in? C
heck all that apply.
Construction
Clerical/Office
Commercial Driving
Maintenance
Cleaning
Packaging/Warehouse
Repair
Other
Other:
How would you rate your day-to-day stability right now?
Very stable - I am in control of my situation and my needs are met.
Somewhat stable - I manage day-to-day, but I have occasional challenges.
Unstable - I regularly face challenges in meeting basic needs.
Very unstable - I am in immediate need of assistance for basic needs.
What type of support are you most interested in?
Check all that apply.
Job search assistance
Resume building and interview preparation
Skill development and training
Access to resources (e.g. housing, transportation, etc.)
Other
Please specify:
How much time are you able to commit each week to a program?
1-2 hours
3-5 hours
6+ hours
Not able to commit to regular hours right now.
Are you interested in participating in a structured program with classes and regular check-ins to support your career growth?
Yes, I am looking for a structured program.
No, I prefer to receive resources without regular commitments.
I would like more information first.
Do you feel ready to work with a coach or mentor to set and achieve your career goals?
Yes
No
Not sure yet
If you were referred to our program please list the person or place who referred you. (
If you weren't please put N/A.)
Thank you for completing this survey! Based on your responses, we will be in touch to discuss the best way to support you.