Membership – Colchester Mosque

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Membership

If you would like to become a member of Colchester Mosque, please fill in the form below or download the form below and give to a member of the committee

Membership fee (subject to review by the committee time to time): Minimum Payment £20.00

Download Membership Form

Title *

Mr
Mrs
Ms
Miss
Dr

Name *

First

Last

Address *

Post Code *

Date of Birth

Telephone Number *

Email *

Are you a UK Citizen

Yes
No

Would you like to volunteer for the Mosque

Yes
No

I consent to receive communications from CICA with general updates from the Management Committee, invitations to member meetings, fundraising, updates regarding events and/or communications in respect of volunteering opportunities

I do not consent to receive communications from CICA

Which country were you born?

What is your primary language?

Do you speak any other languages?

Yes
No

If yes, please provide details:

What ethnic group would you say you belong to:

If other, please specify:

Do you consider yourself to have a disability?

Yes
No

If yes, please provide more details:

Do you consider yourself as

Sunni Muslim
Shia Muslim
Other (please specify)

Other

By checking this box, I hereby certify that the above information is accurate and confirm that the annual membership fee will be paid (payment will need to be received acceptance of any application). If my application is accepted, I will ensure that my actions are in the best interests of the Mosque and will ensure that my behaviour at member meetings, at the Mosque and outside is expected from a responsible Muslim. I am also aware that if my behaviour and/or actions are deemed to be against CICA policy and consitution, I may face disciplinary proceedings which may result in the suspension or termination of my membership

Full Name:

I confirm that I am a UK taxpayer and would like the Colchester Islamic Cultural Association to treat this donation I have made as well as any future donations as Gift Aid, until I notify the otherwise. Please remember that what you pay in income/capital gains tax must at least equal the amount we reclaim against your gift
I do not consent for Gift Aid to be claimed

© 2023. Colchester Islamic Cultural Association is a registered charity in England and Wales (no 293712)
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