Jan 2026 - From Simulation to Change: Leveraging CAPS for Community Impact In-Person Training Pre-Survey

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* 1. First and Last Name

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* 2. Email Address

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* 3. Agency

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* 4. For what group(s) do you anticipate conducting the Poverty Simulation? (For example: medical students, incoming teachers, community officials, social service providers, etc.)

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* 5. Please share your previous experience with the Community Action Poverty Simulation. (Select all that apply.)

I have never seen a Poverty Simulation.

I have only observed (never participated in) a Poverty Simulation.

I have participated in a Poverty Simulation as a family member.

I have volunteered in a Poverty Simulation as a community resource provider.

I have facilitated Poverty Simulations.

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* 6. Does your organization currently experience any difficulties facilitating the Poverty Simulation that you hope will be addressed in this training? Please share more information.

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* 7. What are you hoping to gain from this training?

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* 8. Do you require additional accommodations in order to attend this event? If so, please explain below. A member of staff may reach out for additional information to help coordinate.

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* 9. Do you have any dietary restrictions?