20,000 Dialogues > Dialogues > 20,000 Dialogues Registration

20,000 Dialogues is a nationwide initiative that uses films to facilitate dialogue about Muslims and Islam. Watch the video to learn more.

Sign Up for a Dialogue

Completing this sign-up form is the first step you should take once you’ve decided to host a Living Room Dialogue or a Community Dialogue. This form allows you to choose the free film that you’ll view and discuss in your dialogue. On this form, you will provide 20,000 Dialogues with specific information about your Living Room Dialogue or Community Dialogue, so please have the date for your dialogue chosen. NOTE: Your information will not be shared with any other organization. All Fields Marked With (*) Are Required
First Name: *
Last Name: *
Email: *
Event Name: *
Organization:
Phone: *
Date You Will Be Conducting the Dialogue: *
Are you hosting a Dialogue Party or Living Room Dialogue?: *
Please list the 3 civic groups that you will partner with: *
Film you would like to receive: *
Expected Number of Participants: *
Do you plan on conducting multiple dialogues? *
Are you conducting this dialogue with or through a 20,000 Dialogues partner? *

Shipping Information: Let 20,000 Dialogues know where to send your film.
Address: *

City: *
State: *
Zip Code: *

I verify that: My dialogue group will have at least five participants and that I have made an effort to have participants who are of different faiths, including Muslims, take part. *
I will complete the evaluation and have the other participants do so as well. *

How did you find out about 20,000 Dialogues: *
I would like to list my name and email for others in my area to contact me about joining my dialogue.