Bulling Workshop & Survey Request Form
Please fill out this form to request a CAIR-Texas DFW bullying workshop for Muslim students attending public schools, Islamic schools, and parents who want to talk to their children about bullying. All of our programs are offered free of charge to Islamic institutions. If you have any questions or need assistance please email firstname.lastname@example.org or call (469)290-2909.
Name of Institution
Name of Masjid, Islamic School, Weekend School, etc.
Which Service are you Requesting (You May Choose More Then One Service)
Weekend Schools, Bullying Survey & Workshop for Students Attending Public Schools
Islamic Schools, Bullying Survey & Workshop for Students Attending Islamic Schools
Parents Educational Workshop
Let us get to Know you Better. Tell us About Your Community.
How many students ages 11+, potential dates, about the community, why you are requesting these services.
Any questions for us?
If you have more detailed questions, please email email@example.com or call 469-200-0273
Please verify that you are human
Should be Empty: