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2. ENFIELD POLICE DEPARTMENT ALARM USER APPLICANT REGISTRATION
4. PLEASE TYPE 'YES' UNDER ONE OF THE FOLLOWING:
5. New Registration
6. Prior Registration Remains the Same
7. No Longer Have an Alarm at This Location
9. PREMISE INFORMATION
11. First Name*
12. Last Name*
14. Business Name (If Applicable)
16. Resident or Business Address*
18. City*
19. State*
20. Zip*
22. Mailing Address*
24. City*
25. State*
26. Zip*
28. Premise Phone Number*
29. Business Phone Number*
30. Cell Phone Number
31. Email Address
33. ALARM INFORMATION
35. This is an application to operate an alarm and/or signaling system as indicated:
36. Burglar
37. Hold Up/Panic
38. Fire
40. PLEASE TYPE 'YES' UNDER ALL THAT APPLY:
41. Central Station Monitored
42. Local Alarm ONLY
43. Timed Shut-Off
45. Alarm Installed By
46. Date of Installation
48. Name of Designated Alarm Service Company
49. Phone Number
51. Address
53. City
54. State
55. Zip
57. Name of Central Monitoring Station (where system is monitored)
58. Contact
60. AUTHORIZED KEYHOLDERS
62. Name
63. Date of Birth
64. Cell Phone Number
66. Home Phone Number
67. Business Phone Number
69. Address
71. City
72. State
73. Zip
77. Name
78. Date of Birth
79. Cell Phone Number
81. Home Phone Number
82. Business Phone Number
84. Address
86. City
87. State
88. Zip
92. Name
93. Date of Birth
94. Cell Phone Number
96. Home Phone Number
97. Business Phone Number
99. Address
101. City
102. State
103. Zip
107. Town of Enfield Alarm Ordinance
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109. I ACKNOWLEDGE THE ABOVE INFORMATION IS CORRECT TO THE BEST OF MY ABILITY, AND I UNDERSTAND THE REGULATIONS OF HE TOWN OF ENFIELD ALARM ORDINANCE.
111. Applicant Initials
112. Date and Time Submitted
     Date and Time Submitted

     Date and Time Submitted
Leave This Blank:


114. 1. Receive an email copy of this form.
115. Email address

     This field is not part of the form submission.

116. Submit

* indicates a required field