Online Application Form

Name of your mosque/Islamic centre:

Your Name:

Your email address:

Your Position:

Your direct contact:

Please give a brief history of your mosque
(i.e. when was it formed, how was it funded, approx size of congregation?)

Please list religious services you provide for the Muslim community in your area

Religious Services

Teaching Prayers Services for sisters

Education for children Other

Please list any additional services you provide:

Additional Services

Shahadas Weddings Funerals/Bereavement

Circumcision Counselling Other

Describe your mosque’s relationship with the local host community
(i.e. police, local MP/councillors, churches, schools, NHS etc)

Tick any external events/activities you have organised through the mosque

External events/activities

Religious talks/seminars Exhibitions Youth activities

Competitions Mela’s Fund Raising

Describe your relationship with local media outlets in your area.
Do you have a dedicated media officer?

Entrants Profile

A profile of the mosque

Information about the mosque's activities [Maximum 300 words]

3 Pictures showing the inside of your mosque

Picture 1

Picture 2

Picture 3

3 Pictures of the outside of the mosque

Picture 1

Picture 2

Picture 3