Simulation Request Form – Poverty Studies

Name*
First Last
Email*
Phone*
Organization or Department*
Please describe why you are interested in offering a poverty simulation, including any learning objectives for your participants.*
What is your planning timeline and scheduling preference, including any specific dates and times you would prefer to offer the simulation?*
Estimated Number of Participants*
In order to conduct a simulation with each of the family types represented, the minimum number of participants is 25. If your group or organization has less than this, we recommend partnering with another group.
Will your organization be able to provide approximately 20 volunteers for the simulation?*
Please initial below if you are able to provide a location to accommodate the simulation and are able to complete a room setup prior to UCA staff arriving to the simulation (map will be provided).*