Registrant Input

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* 1. First and Last Name

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* 2. Email Address

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* 3. What sector do you work in? (Ex: Community Action, K-12 education, non-profit, higher education, social services, etc.)

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* 4. For what group(s) do you anticipate conducting the Poverty Simulation? (ie- medical students, incoming k-12 teachers, social service providers, etc.)

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* 5. What is your prior experience with the Community Action Poverty Simulation? (Please select all that apply)

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* 6. If you've facilitated, participated in, or observed a Community Action Poverty Simulation, please describe a situation that occurred that was unexpected or especially trying. Please also describe how the situation was handled. We will use these examples as case studies in the training.

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* 7. Do you currently experience any difficulties with the Poverty Simulation that you would like addressed at the training?

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* 8. What are you hoping to gain from the facilitator training?

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* 9. How do you best learn?

Thank you for taking the time to complete this survey. If you have further questions, comments, or suggestions regarding the CAPS Facilitator Virtual Training, please contact Evan Melkersman at povertysimulation@communityaction.org or (573) 634-2969 Ext. 26. I look forward to meeting you!

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