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Faculty/Staff Poverty Simulation Interest Form
This form is for faculty and staff interest only. If you are a student interested in the poverty simulation, please contact your instructor or department.
Faculty/Staff Name
(*)
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Title
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Email
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School
(*)
UAB School of Medicine
UAB School of Nursing
UAB School of Health Professions
UAB School of Dentistry
UAB School of Optometry
UAB School of Public Health
UAB College of Arts & Sciences
UAB School of Education
UAB School of Business
UAB School of Engineering
Other
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Department
(*)
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Please check your area of interest(s)
(*)
Sending my students to the Poverty Simulation
Serving as a small group debriefer for the Poverty Simulation
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Please select your approximate number of learners
<10
11-20
21-30
31-40
41-50
50-100
>100
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Expected level of learners
Undergraduate
Graduate Program
Professional Degree Program
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What time of year would you prefer to have students involved? (check all that apply)
Fall
Spring
Summer
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(*)
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Submit