Voluntary Camera Registry

2. Name / Primary Contact *

   Please enter the full name of the primary contact.

4. Email Address

   Primary contact email address.

5. Phone Number*

   Please enter the contact number of the primary contact.

7. Address*

   What is the full address where the system is located?

9. Residential or Business? *

   1. Business
   2. Residential

   Please choose whether you are registering a residential or business camera system.

11. Business Name

    If applicable

12. Video Retention Time*

    How long is the video stored on your DVR? (Answer in days, we recommend 14 days)

14. Do you have a live feed? *

    1. Yes
    2. No

15. Number of Cameras?*
    -- Select One --12345678910+

17. Areas of Coverage*

    Please select all areas of coverage that apply.

    1. Front Entry
    2. Back Entry
    3. Side Yard
    4. Street
    5. Parking/Vehicle
19. Streets of Coverage

    If you choose "Street, parking, or vehicle areas" area in previous question, please specify which streets, parking, or vehicle areas.

Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field