PEORIA POLICE DEPARTMENT
BUSINESS ALARM REGISTRATION FORM
(Please PRINT Clearly)

NAME OF BUSINESS: 							     
DATE: 					
STREET ADDRESS:  									 
PEORIA, AZ  			
(ZIP CODE)
MAILING ADDRESS:  									
(IF DIFFERENT FROM STREET ADDRESS)

TELEPHONE NUMBER(S):  (		          )										
NORMAL BUSINESS HOURS:  FROM 	    AM / PM    TO  	   AM / PM

DAYS OF WEEK OPEN FOR BUSINESS:    ()  SUN       ()   MON      ()   TUE      
()   WED       ()   THU       ()   FRI       ()   SAT	

()  YES     ()  NO    DO YOU HAVE A SECURITY GUARD OR GUARD DOG ON THE PREMISES?		
()  YES     ()  NO    DO YOU HAVE A VISION OBSCURING DEVICE?
()  YES    ()  NO     IS THERE HAZARDOUS MATERIALS AT THE BUSINESS?   
IF YES, EXPLAIN WHAT TYPE:	
															

ALARM COMPANY:  													
ADDRESS:  														
TELEPHONE NUMBER(S):  (		         )										
MONITORING ALARM COMPANY:  											
24-HOUR ALARM COMPANY TELEPHONE NUMBER:  (		)							
TYPE OF ALARM:	()    AUDIBLE	()    SILENT	()   BURGLARY
		()   ROBBERY	()    PANIC	()   OTHER  								
MISCELLANEOUS INFORMATION:  											
															


1ST PERSON TO NOTIFY IF ALARM IS ACTIVATED 
NAME:  														
HOME TELEPHONE:  (	        )	WORK PHONE:  (              )				
PAGER:  (	  )			CELLULAR:  (	        )					

2ND PERSON TO NOTIFY IF ALARM IS ACTIVATED (OTHER THAN OWNER)
NAME:  														
HOME TELEPHONE:  (	        )	WORK PHONE:  (	         )	
		
PAGER:  (	  )			CELLULAR:  (	        )					


PLEASE RETURN THIS FORM TO:	

PEORIA POLICE DEPARTMENT
ATTENTION:  ALARM COORDINATOR
8351 West Cinnabar Ave.
PEORIA, ARIZONA  85345
Phone: (623) 773-7017
Fax: (623) 825-6514
alarms@peoriaaz.gov					


103-012   DEC99