New Customer Form

New Customer Form

Welcome!
General Account Info
Customer ID
Site ID
Job ID
Completed From
Completed form via
Name*

First NameLast Name
Home Address*

Street Address Line 2
Phone Number *
CellHome
Email*
example@example.com
Billing Preferences
How do you want to receive invoices?*

Email (Preferred)MailEmail & Mail
Who is the billing contact?*

MeSomeone else
Billing Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
What is the billing address?

Same as home addressDifferent address
Billing Address*

Street Address

Street Address Line 2

CityState

Zip Code

Emergency Contacts

These are the individuals we will for contact for emergencies (i.e. break-in detected, smoke detected, etc) and non-emergency troubles (i.e. low battery, power failure, etc).
BEFORE-DISPATCH Contact List

For EMERGENCIES: we'll text (all contacts immediately) and call (individually, in order) BEFORE the authorities are called. These individuals can either request to dispatch the authorities or disregard if they aren't needed. For NON-EMERGENCIES: these individuals will receive a text alert with a link to either request service or place the signal on "disregard". This list usually contains the home's primary occupants.
For EMERGENCIES (break-in detected, smoke detected, etc): we'll text (all contacts immediately) and call (individually, in order) BEFORE the authorities are called. These individuals can either request to dispatch the authorities or disregard if they aren't needed.
For NON-EMERGENCIES (low battery, power failure, etc): these individuals will receive a text alert with a link to either request service or place the signal on "disregard".
This list requires a minimum of 1 contact and a maximum of 2; typically it includes the home's primary occupants.
*** Landline Note ***

Landlines will receive phone calls for emergencies, but will not receive text messages for non-emergency trouble conditions. Phone calls are for emergencies only. If you prefer to use a landline, we highly recommend also entering your email to be alerted of trouble conditions.
AFTER-DISPATCH Contact List

For EMERGENCIES: we'll call this list (individually, in order) AFTER the authorities have been sent. For NON-EMERGENCIES: these individuals will receive a text alert with a link to either request service or place the signal on "disregard". This list often includes friends, family members, or neighbors.
For EMERGENCIES (break-in detected, smoke detected, etc): we'll text (all contacts immediately) and call (individually, in order) AFTER the authorities are called.
For NON-EMERGENCIES (low battery, power failure, etc): these individuals will receive a text alert with a link to either request service or place the signal on "disregard".
There is no minimum on this contact list; typically it includes friends, family members, or neighbors.
*** Landline Note ***

Landlines will receive phone calls for emergencies, but will not receive text messages for non-emergency trouble conditions. Phone calls are for emergencies only. If you prefer to use a landline, we highly recommend also entering your email to be alerted of trouble conditions.

Verbal Password(s)
What is a verbal password?

When the alarm goes off and we call the before-dispatch contact list to verify if you need the authorities, the dispatcher will verify that you have the authority to disregard the alarm by asking for your verbal password. It should be memorable, but something only you would know. People often use a pet's name, a favorite vacation spot, or even a set of numbers.

Note: this is different from the code you enter into the alarm to disarm, though it can be the same.
Words and numbers only. No spaces! Use capitalization to separate words if needed (i.e. PuppyDog, SpaceBalls123, etc.) *

A Few More Things...
How did you hear about us?*
Who referred you?
Other - can you specify?
Would you like a short "test period" after your installation so you have time to get used to your new security system? (You'll be able to use the system normally, but the police will not be called if there is an alarm).*

No test period (account will be live as of 7pm on the date the installation is complete)24-hour test period48-hour test period
Should be Empty:

General Account Info

Billing Preferences

Emergency Contacts

BEFORE-DISPATCH Contact List

*** Landline Note ***

AFTER-DISPATCH Contact List

*** Landline Note ***

Verbal Password(s)

A Few More Things...

* Landline Note *

* Landline Note *