Request edit access
Discrimination Focus Group
CAIR-Chicago & the Chicago Commission on Human Relations invite you to fill out this short survey.  Criteria: 1) You must be Muslim, 2) You must have faced discrimination in one of the below categories.

Based upon responses, Focus Groups will be scheduled in mid-November.  Those selected will be contacted by mid October.

Thank you!

For any questions, please contact CAIR-Chicago Deputy Director Sufyan Sohel @ssohel@cair.com


* The purpose of the focus groups are so that CAIR-Chicago & the Chicago Commission of Human Relations can listen to members of the Muslim community and better serve them.  
**All answers submitted here & any statements made in the focus group will remain confidential.
Sign in to Google to save your progress. Learn more
Name *
What time of day is best for you to participate in the Focus Group (all will be held at CAIR-Chicago - 17 N State, Chicago, IL) *
Age *
Race or Ethnicity (how do you identify?) *
In which area(s) have you experienced discrimination? (Please select all that apply.) *
Required
Because of which of the following have you faced discrimination? (Please select all that apply.)
Please share a short summary of your experience: *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms