2. 

   Please fill out this request form to receive a free gun lock in the mail.

   Note: Due to very limited supply, we are currently only able to accommodate requests from residents of Shelby County, TN. Only one per household may be ordered

   
   

4. First Name*
5. Last Name*
7. Address1*
9. City*
   -- Select One --ArlingtonBartlettColliervilleGermantownLakelandMemphisMillington
10. State*
    -- Select One --TN
11. Zip*
13. Phone Number
14. Email Address
16. Why is participating so important to you (optional)?
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18. 1. Receive an email copy of this form.
19. Email address

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20. Submit

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