EMERGENCY CALL LIST SET-UP FORM

We require EMERGENCY CALL Information added to any new account in order for us to to respond properly to your alarm conditions. 

These numbers will be used to contact a responsible party AFTER the authorities have been contacted.

Once your account has been set-up, you can also add, delete or change these contact numbers online anytime by visiting www.GoToMyAlarm.com

To complete this form, please use your PERMANENT or TEMPORARY ACCOUNT NUMBER. 

  CONTACT PHONE NUMBERS 

 24 HOUR ALARM CENTER 1-800-765-2580

 ALARM COMPANY BUSINESS OFFICE 1-800-365-2527

* Required fields
Name *
E-mail Address *
8 DIGIT ALARM ACCOUNT NUMBER *
THIS FORM IS FOR *	NEW ACCOUNT INFORMATION UPDATING OF EXISTING ACCOUNT
ALARM IS LOCATED IN A *	RESIDENCE (HOUSE) RESIDENCE (APT/CONDO) BUSINESS
ACCOUNT NAME *
ALARM PREMISES ADDRESS LINE #1 *
ADDRESS LINE #2
STATE *	Alaska Alabama Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming (NOT ON LIST)
CITY *
Zip Code *
IF EXISTING ACCOUNT, PLEASE PROVIDE YOUR PASSWORD
IF NEW ACCOUNT, PLEASE SELECT A SECRET PASSWORD TO CANCEL ALARMS (MAXIMUM 12 SPACES)
AREA CODE & PHONE NUMBER FOR ALARMED PREMISES (CALLED FIRST) *
WHEN DO YOU WANT POLICE CALLED? *	Call Premises First For Password. Then Police if No Answer or Password. Then Emergency Contacts Listed Below. Call Premises First, Then Emergency Contacts Listed Below For Password. Then Police if No Answer or Password.
NAME OF EMERGENCY CONTACT PERSON #1
CONTACT IS	THE HOME OR BUSINESS OWNER A FRIEND A RELATIVE A NEIGHBOR EMPLOYEE/MANAGER EMPLOYEE/NON-MANAGER VENDOR
AREA CODE & PHONE NUMBER
CONTACT NUMBER IS A	HOME PHONE WORK PHONE CELLULAR PHONE PAGER (HOLD FOR 10 MIN. FOR RESPONSE) eMAIL (LAST ON LIST ONLY)
NAME OF CONTACT PERSON #2
CONTACT IS	THE HOME OR BUSINESS OWNER A FRIEND A RELATIVE A NEIGHBOR EMPLOYEE/MANAGER EMPLOYEE/NON-MANAGER VENDOR
AREA CODE & PHONE NUMBER
CONTACT NUMBER IS A	HOME PHONE WORK PHONE CELLULAR PHONE PAGER (HOLD FOR 5 MIN. FOR RESPONSE) eMAIL (LAST ON LIST ONLY)
NAME OF CONTACT PERSON #3
CONTACT IS	THE HOME OR BUSINESS OWNER A FRIEND A RELATIVE A NEIGHBOR EMPLOYEE/MANAGER EMPLOYEE/NON-MANAGER VENDOR
AREA CODE & PHONE NUMBER
CONTACT NUMBER IS A	HOME PHONE WORK PHONE CELLULAR PHONE PAGER (HOLD FOR 5 MIN. FOR RESPONSE) eMAIL (LAST ON LIST ONLY)
NAME OF CONTACT PERSON #4
CONTACT IS	THE HOME OR BUSINESS OWNER A FRIEND A RELATIVE A NEIGHBOR EMPLOYEE/MANAGER EMPLOYEE/NON-MANAGER VENDOR
AREA CODE & PHONE NUMBER
CONTACT NUMBER IS A	HOME PHONE WORK PHONE CELLULAR PHONE PAGER (HOLD FOR 5 MIN. FOR RESPONSE) eMAIL (LAST ON LIST ONLY)
NAME OF CONTACT PERSON #5
CONTACT IS	THE HOME OR BUSINESS OWNER A FRIEND A RELATIVE A NEIGHBOR EMPLOYEE/MANAGER EMPLOYEE/NON-MANAGER VENDOR
AREA CODE & PHONE NUMBER
CONTACT NUMBER IS A	HOME PHONE WORK PHONE CELLULAR PHONE PAGER (HOLD FOR 5 MIN. FOR RESPONSE) eMAIL (LAST ON LIST ONLY)
NAME OF CONTACT PERSON #6
CONTACT IS	HOME OWNER RELATIVE NEIGHBOR BUSINESS OWNER/PRINCIPLE EMPLOYEE/MANAGER EMPLOYEE/NON-MANAGER VENDOR
AREA CODE & PHONE NUMBER
ANY SPECIAL DISPATCH COMMENTS FOR ACCOUNT

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