* 1. Full Name

* 2. City and State

* 3. Email address

* 4. How are you planning to help prevent gun violence?

* 5. Are you willing to share a copy of your khutba (written or audio-visual) or your op-ed with us? If yes, someone from our staff will contact you directly by e-mail.

* 6. Please share any comments you may have with us.