Response

News from Representative Robin Kelly

Please take a moment to share with Congresswoman Kelly how gun violence has impacted you or your community.

Prefix

First Name

Last Name

Address Line 1

Address Line 2

City

State

Zip

Email

Phone

Where do you live?

What is your age?

Under 18
18-25
26-35
36-45
46-55
56-65
66-75
76-85
86+

Have you been personally affected by an instance of gun violence?

Yes

No

Other (please specify)

How have you been impacted by gun violence?

I have been hurt

A family member has been hurt

Someone I know has been hurt

I have seen or heard of instances in my community

I have not been personally impacted by gun violence

When considering gun violence, do you feel safe in your community?

Yes

Most of the time

Sometimes

Rarely

No

Are you aware of gun violence prevention efforts in your community?

Yes

No

I would like to learn more

Do you think we need additional federal gun violence prevention legislation?

Yes

No

I'm not sure

If you would like to share a personal story about how gun violence has impacted you, please do so here. Stories will not be shared publicly without your written permission.

If you shared a personal story, may my office contact you to learn more about your experience?

Yes

No

By completing this survey I understand that I am opting to receive future communication from the Office of Congresswoman Robin Kelly.

Washington D.C. Office
1239 Longworth H.O.B.
Washington, D.C. 20515
Phone: (202) 225-0773
Fax: (202) 225-4583
hours: M-F 8:45 AM - 5:30 PM

Matteson Office
600 Holiday Plaza Dr.
Suite 505
Matteson, IL 60443
Phone: (708) 679-0078
Hours: M-F 9:00 AM - 5:00 PM

Kankakee Office
304 South Indiana Ave.
Kankakee, IL 60901
Phone: (708) 679-0078
Hours: Second and fourth
Wednesdays of each month 9:00 AM - 4:30 PM

Unsubscribe | Privacy Policy