SP_Report Survey

After conducting a discussion regarding the Straight Path, please fill out this survey in order to share with others the outcome of the discussion, and to leverage it for the future.

1. Please provide the following information

Please provide the following information Meeting date:
Facilitator Name:
Speaker (if any):
City:
State:
Email Address:

2. Name and email of individual who filled this form?

Name and email of individual who filled this form?

3. Name and email of the person taking notes during the discussion.

Name and email of the person taking notes during the discussion.

4. Where was discussion held

Where was discussion held Usra of MY Connect

Masjid halaka

Town Hall

private meeting

MAS Youth Committee Meeting

Other MAS committee meeting

MSA meeting

Islamic Center Board

Other (please specify)

5. How many people attended discussion?

How many people attended discussion?

6. If session taping is placed online, please indicate site :

If session taping is placed online, please indicate site :

7. How long was the discussion?

How long was the discussion?

8. Describe the format of the discussion.

Describe the format of the discussion.

9. Describe the composition of the attendees. Check all boxes who were part of the discussion.

Describe the composition of the attendees. Check all boxes who were part of the discussion. 2nd Generation Muslims

First generation immigrants

Males

Females

Converts

African Americans Muslims

White Americans Muslims

Latino American Muslims

Indian subcontinent

Arab/Middle Eastern Muslims

Asian Muslims

African Muslims

European Muslims

non-Muslims

18-28 years old

12-18 years old

28-30 years old

30-40 years old

40+ years old