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Academic & Career Advising Screening Form
This form helps us understand your background, goals, and career capital so we can tailor your 1-on-1 advising session.
1. Personal Information
Full name
*
Age
*
Gender
*
City
*
Country
*
Email
*
WhatsApp number
2. Academic Background
Education status
*
Highest level of education completed
*
Field of study / Academic discipline
*
Institution / University
*
Country of education
*
3. Professional experience
Years of professional experience
*
A
None
B
<1 year
C
1-3 years
D
4-7 years
E
8-10 years
F
10+ years
Employment status
*
A
Student
B
Intern
C
Job seeker
D
Employed full-time
E
Employed part-time
F
Freelancer
G
Entrepreneur
H
Career transition
Current role / Industry
*
4. Career direction
Which best describes your career orientation?
*
A
Generalist (broad interest)
B
Specialist (deep focus)
C
Not sure yet
Wich type of work most interests you?
*
A
Technical: Work using specialized tools or expertise to build systems or design/implement programs
B
Operational: Day-to-day execution that keeps systems or organizations running (e.g., logistics, scheduling, support).
C
Strategic: High-level planning and decision-making about direction, goals, and priorities.
D
Creative: Generating original ideas or content such as writing, design, music, or campaigns.
E
Entrepreneurial: Creating and growing ventures through risk-taking, experimentation, and opportunity-building.
F
Hybrid: A mix of two or more categories
G
Not sure: Tasks that are vague, undefined, or lack enough context to classify.
Current opportunity being pursued (select all that apply)
*
What is your biggest challenge right now? Select all that apply
*
5. Career Capital Diagnostics
(a) Transferable skills: Rate your self on a scale of 1-10 your current level of each skill below
Communication – Clearly expressing ideas so others understand and act
*
0
1
2
3
4
5
6
7
8
9
10
Critical Thinking – Analyzing information to make sound decisions
*
0
1
2
3
4
5
6
7
8
9
10
Adaptability – Adjusting quickly to change and new situations
*
0
1
2
3
4
5
6
7
8
9
10
Collaboration – Working effectively with others toward shared goals
*
0
1
2
3
4
5
6
7
8
9
10
Problem-Solving – Identifying issues and finding practical solutions
*
0
1
2
3
4
5
6
7
8
9
10
Time Management – Prioritizing tasks and using time efficiently
*
0
1
2
3
4
5
6
7
8
9
10
Digital Literacy – Using technology and data effectively
*
0
1
2
3
4
5
6
7
8
9
10
Creativity – Generating new ideas or better ways of doing things
*
0
1
2
3
4
5
6
7
8
9
10
Self-Management – Staying disciplined, accountable, and consistent
*
0
1
2
3
4
5
6
7
8
9
10
Influence & Leadership – Guiding and motivating others, even without authority
*
0
1
2
3
4
5
6
7
8
9
10
(b) Social capital (Network and connections)
Which do you current have acess to? Select all that apply
*
How often do you network intentionally?
*
A
Never
B
Rarely
C
Sometimes
D
Often
E
Very often
(c) Signaling Capital (Reputation)
Which of these do you currently have? Select all that apply
*
(d) Character capital
What most affects your career or academic growth right now?
*
A
Fear / Self doubt
B
Burnout
C
Low confidence
D
Poor consistency
E
Time management
F
Imposter syndrome
G
Decision fatigue
H
Lack of disciipline
I
None
J
Other
(e) Financial runaway and tools
Which of these career develop options can you currently pay for without a scholarship? Select all that apply
*
For how long are you willing to and can pursue an unpaid career development activity?
*
A
Cannot pursue an unpaid opportunity
B
3 months
C
6 months
D
12 months
E
24 months
F
36 months
Do you own a personal laptop computer?
*
A
Yes
B
No
Do you have unlimited access to internet at home
*
A
Yes, i have unlimited Wifii at home
B
No, I use limited mobile bundles at home
C
No, I use wifi from school, office, or public library
D
No,I do not currently have acess to the internet
6. Goals and Outcomes
What is your main academic or career goals in the next 12-24 months (Max 100 words)
*
Which social impact field of study or work are you most interested in?
*
Which field of work by industry most interests you
*
Where do you need the most support
*
Upload your CV (Max 3 pages)
*
Click to choose a file or drag here
Size limit: 10 MB
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