Survey

YOU MUST BE AGED 18 OR ABOVE TO COMPLETE THE SURVEY

NAME(required)

HOUSE NAME/NUMBER(required)

POST CODE(required)

HOW DO YOU TRAVEL TO HICC?(required)

HOW LONG DOES YOUR JOURNEY TAKE?(required)

HOW OFTEN DO YOU VISIT?(required)

HOW LONG HAVE YOU ATTENDED?(required)

WHICH SERVICES DO YOU USE?(required) Prayer

Madrassah

Soup Kitchen

Food Bank

HOW OLD ARE YOU?(required)

DO YOU HAVE ANY CHILDREN UNDER THE AGE OF 18(required) Yes

IF SO HOW MANY OF YOUR CHILDREN ATTEND THE MOSQUE

COMMENTS

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