106 S Lincoln Ave., Urbana, Illinois 61801, USA
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I, the undersigned, request regular membership in the Central Illinois Mosque & Islamic Center (CIMIC). I certify that I am over 18 years of age, I am a Muslim, and I reside within the counties served by CIMIC. I agree to abide by the CIMIC Constitution and all CIMIC regulations and policies, including the CIMIC membership policies. I understand that this application does not guarantee me membership in CIMIC, and that my application is subject to review. I understand that if I am granted regular membership, I shall only become a voting member six months after the date that my membership takes effect. I understand that I must maintain eligibility and current membership in order to retain my status as a voting member.
Additionally, I certify that all information provided by me in this application is accurate and conforms to local and national laws.
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