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2. Residential or Business?

   1. Residential

   1. Business
3. Number of Cameras
   -- Select One --12345678910+
5. Business Name
7. Street Number*
8. Street Name*
10. Last Name (Primary Contact)*
11. First Name (Primary Contact)*
13. Telephone # (Primary Contact)*
    example: (XXX)123-1234
15. Email Address (Primary)*
    Example: 124@anywhere.com
17. Secondary Contact Person & Telephone Number
    Full name and telephone number
19. Video Storage Length*
    How long is the video stored on your DVR/NVR?
21. Do you have a live feed?*

    1. Yes
    2. No
23. What areas do the cameras cover? You may select more than one option

    1. Front Entry

    1. Back Entry Areas

    1. Side Yard Areas

    1. Street, Parking or vehicle areas
Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit

* indicates a required field