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2. Official Alarm Application
   This application is hereby made for registration of a burglar/fire alarm system with Pequannock Police Headquarters in accordance with Township Code Chapter 41.
4. Name*
5. Email Address*
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
15. Name of Alarm Company*
16. Alarm Company Phone Number*
18. Emergency Contact Information
    This is who you would like us to contact in an emergency. Consider another family member, neighbors, etc.
20. Name*
21. Phone Number*
23. Name
    This is optional if you'd like to provide a second emergency contact.
24. Phone Number
26. Type of Alarm

    1. Burglar
    2. Fire
    3. Both
27. Additional Information
    If there is anything else you believe we should know (such as pets in the home or if we should contact specific people between specific hours), please let us know.
29. Signature*
    Please type your full name. This will be considered the equivalent of physically signing the paper version of this form, swearing that all information provided is true to the best of your knowledge.
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field