Imaan LGBTQI Membership Form
July 2017

We understand that completing a form such as this may be a challenge for some people who wish to join Imaan. We are aware and sensitive to working with people at all stages of their life and the understanding they have of their sexuality and gender identity. Equally, we appreciate the need for discretion and value your privacy. Below are some instructions to help you complete this form that take into account the concerns many may have with such an exercise.

No information provided will be shared or made public outside of Imaan.

Instructions for completing the form:

1.Initial and Surname – We have asked you for the initial of your first name, and full surname, as this affords a degree of anonymity should you be concerned about sharing your name on this form. Your DOB (date of birth) merely helps Imaan form a demographic ‘picture’ of its members.

2. Gender – We have specified a five options but appreciate that there are many ways in which people understand and express their gender identity. Should you not identify with the options given, please tick ‘Other’.

3. Postcode – We have asked for a postcode as this helps Imaan form a demographic picture of its members.

4. Ethnicity – We have asked you to specify your ethnicity, but understand that this may be more complex for some people. Please choose what you feel comes close to representing you and or, specify how you may describe yourself in your own words. We have asked for this information as it helps Imaan form a demographic ‘picture’ of its members.

5. Religion – We understand that Imaan’s identity is of a Muslim LGBTQI organisation, however, membership is open to all Muslim LGBTQI people, their supporters and approved organisations.

6. Sexual Orientation – We have asked you for your sexual orientation, as this helps us form a demographic ‘picture’ of our members. We have provided a number of options, but these are not exhaustive or exclusive. Please tick one or more and/or the box marked ‘other’, should none of the options provided describe your sexual orientation accurately.

7. Disability – We have asked about this as it helps us form a demographic ‘picture’ of members

8. Email address – PLEASE provide a valid email address, as this is our preferred means of communication.

9. Phone number - PLEASE provide a valid telephone number where we can contact you to verify your registration.
Email address *
Name *
Gender *
Postcode *
Ethnicity *
Religion *
Sexual Orientation *
Clear selection
Contact number *
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