Type Full Name :
Sign With Hand
State
State
Address
First Name *
Address
Medical
The fee for this application will be calculated upon approval. You will receive a request for payment by email.

Payments may be made by
1) Credit Card online (details will be in the body of the email)
2) Check or money order by mail
3) Credit card, cash, or money order in-person.

Last Name *
Medical needs information
Property Details
Business Hours: Closing Time
Business Hours: Opening Time
Selected Address *
Burglar
Alarm automatically
Property Type *
Applicant Details
Phone # *
Block
minutes
Audible
Business Information
Fire
Owner Cell
Name
City
Building Owner Phone #
Phone Number
Fee Schedule
Phone #
Applicant Signature *
Address *
Number of Animals
Person in Control of Property Email
Owner Phone #
Any animals in residence or business?
Registration Type
{[CNAME]}
{[ADDR]}
{[CITY]}, {[STATE]} {[ZIP]}
{[APHONE]}
{[AWEBSITE]}
Business Type
City
ZIP
Alarm Information
Emergency Contacts
Note: Alarm must shut off or reset within 15 minutes.
Company Name (if applicable)
Certification
Building Owner Cell
Building Owner Name
Special Conditions or Hazards
Information/hazards for police officers or fire personnel
Lot
Hold-Up
Carbon Monoxide
Owner Name
ZIP
Reset Code
in
Cell Phone #
Other
Silent
Email *
Type of Animals
Alarm Types (Check all that apply) *
Panic
Alarm Company
Name and phone number of AT LEAST ONE person who are familiar with system and have password and/or keys to be contacted in case of alarm and/or malfunction of alarm system. They should be able to respond in a reasonable amount of time. *
Person in Control of Property
{[PNAME]}
Reset Type
I hereby certify that I,

1) I understand that to cancel a false alarm activation I must call my alarm company and give them my proper cancellation code.

2) I have been instructed by the alarm company on how to properly operate my alarm system.

3) I have the monitoring company’s telephone number to use for cancellations, to test my alarm, to update telephone contact information and to request alarm service or repairs.

4) I understand that I cannot cancel a robbery/panic alarm activation.

5) I will instruct ALL alarm users on how to operate the alarm system, how to cancel a false alarm activation and will provide them with a proper cancellation code.

By submission of this alarm registration application, I hereby affirm that the information is true and correct.


This registration is valid for two years, from January 2021 through January 2023.