Forms • Town of Paradise Valley, AZ • CivicEngage

Alarm Subscriber Information Sheet

Leave This Blank:

Date*

Subscriber Name*

Password
**Your password should be easy for you to remember. You must provide a password to stop or cancel police response.*

Subscriber Phone Number*

Paradise Valley Address:*

Mailing Address*

Subscriber Email*

Primary Contact Name:*

Primary Contact Phone Number:*

Primary Contact Email:*

Secondary Contact Name:

Secondary Contact Phone Number:

Secondary Contact Email:

Additional Contact 1 Name:

Additional Contact 1 Phone Number:

Is Additional Contact 1 a Key Holder?

Additional Contact 2 Name:

Additional Contact 2 Phone Number:

Is Additional Contact 2 a Key Holder?

Please indicate if you would like to receive notifications via the emails provided for non-emergency notification signals.

Please indicate if you would like to receive SMS or email notifications for burglar signals received. By selecting SMS notification, you will receive notification via text message when the event occurs. Attempts will still be made by dispatch to contact you per our procedure.

Yes

If you selected yes to revive SMS notifications for burglar signals please fill in your Phone Number.
You must provide the phone number and SMS provider’s email. For example, if you have Verizon please indicate 1234567891@vtext.com

* indicates required fields.

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