Cost of Poverty Experience Registration
Register to participate in the Cost of Poverty Experience event. Please complete all sections to help us prepare for your visit.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Organization / School / Company (if applicable)
Which session would you like to attend?
*
Please Select
Morning Session (9:00 AM – 12:00 PM)
Afternoon Session (1:00 PM – 4:00 PM)
Evening Session (5:00 PM – 8:00 PM)
Other (please specify below)
If you selected 'Other', please specify your preferred session time:
Do you have any accessibility needs or dietary restrictions?
How did you hear about this event?
*
Please Select
Workplace/School
Friend/Colleague
Social Media
Email Newsletter
Other
Briefly, why are you interested in participating in the Cost of Poverty Experience?
Emergency Contact Name
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Register
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