FAIR LAWN POLICE DEPARTMENT ALARM REGISTRATION

Please complete all of the information on this form and click the submit button when completed.  If you would rather print the form and mail, fax, or drop it off at police headquarters, click here.  If you have any questions, call 796-1400 and ask for a Community Policing Officer.

1.  Name: 

2.  Address:    Suite/Apt. #

3.  Area Code:    Phone: 

4.  Alarm Type (check all that apply):Burglar Fire Hold up Panic Medical

5. PD called by (mark all that apply)Tape/Dialer Audible device Central station    

6.  Monitoring Company Name: 

7.  Address: 

8.  City:   

9.  State:     

10.  Zip:   

11.  Area Code:   

12.  Phone: 

13.  Emergency Contact #1 Name:           
       Phone: 

14.  Emergency Contact #2 Name:       
       Phone: 

15.  Emergency Contact #3 Name:      
       Phone: 

16.  Remarks: