Human Services Entry Form

1
This survey will help the founder and human researcher callibrate their approach. Please do your best to complete this, the more information the better your human experience and recommendations.
2
Please verify that you are human* This field is required.
3
Country* This field is required.Help Being Services know where we can be helpful
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
4
US State* This field is required.Help Being Services know where we can be helpful
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
5
Name* This field is required.How do you refer to yourself?
6
Please enter your email address* This field is required.Enter an email so I can follow up with you
example@example.com
Confirm Email
7
Please tell me a little bit about yourself and your situation. What would you like to achieve in your life, career, or business?* This field is required.
"I am a human, not a genie" - Founder of Human Services
8
Please select the services you 1 - do not need, 2 - somewhat need, or 3 - need.* This field is required.
1 - I do NOT need it
2 - I somewhat need it
3 - I need it
Resume/Interview Prep
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Career Advice
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Company/Recruiter Matching
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Something else
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Resume/Interview Prep
Career Advice
Company/Recruiter Matching
Something else
1 - I do NOT need it
Row 0, Column 0
2 - I somewhat need it
Row 0, Column 1
3 - I need it
Row 0, Column 2
1 - I do NOT need it
Row 1, Column 0
2 - I somewhat need it
Row 1, Column 1
3 - I need it
Row 1, Column 2
1 - I do NOT need it
Row 2, Column 0
2 - I somewhat need it
Row 2, Column 1
3 - I need it
Row 2, Column 2
1 - I do NOT need it
Row 3, Column 0
2 - I somewhat need it
Row 3, Column 1
3 - I need it
Row 3, Column 2
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Please tell me more about what you need, if you rated "something else" as 2 - I somewhat need it or 3 - I need it. (Otherwise, enter na)
10
How urgent are your needs?* This field is required.
I need these services today
I need these services in a week
I need these services in the next few months
I need these services in the distant future
I do not need these services at all
11
How likely are you to recommend our product to a friend or colleague?* This field is required.
1
2
3
4
5
6
7
8
9
10
Very Unlikely
Very Likely
12
Would you interact with our services again?* This field is required.
Yes
No
13
Please share any constructive feedback on Being Services (services & features you want to see)* This field is required.
"I am a human, not a genie" - Founder of Human Services
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