Mosque Visit Survey
Central Illinois Mosque and Islamic Center (CIMIC)
Outreach Committee

The information you provide us will hopefully help us improve future visits to CIMIC. Thank you very much for your feedback!
Sign in to Google to save your progress. Learn more
Date of Visit (if known)
Was your visit an individual visit or group visit?
"Group" refers to when a class or other professional group arranges for a collective visit via a group leader such as a professor. If you were just a group of friends who came together, please mark "Individual".
Clear selection
* If your visit was an INDIVIDUAL visit: How did you learn about CIMIC?
Clear selection
** If your visit was a GROUP visit: Please identify the group.
e.g. Prof. John Smith's Class, XYZ Leadership Team, etc.
Was this your first visit to a mosque?
Clear selection
What did you find most interesting about the mosque tour, question and answer session, or anything else during the visit?
What would you have liked us to cover during your visit that was not covered? Is there any part of the visit which you feel could be improved?
How has the visit affected your perceptions of Islam?
Was there anything that you disliked about the visit or that made you feel uncomfortable?
Did you feel that the Q/A session was satisfactory?
Not at all
Clear selection
If you would like us to contact you about visiting the mosque again for follow-up discussions, please leave your contact information below and we will reach out to you. You can also send us an email to
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy