2. Business Name:*
4. Business Address:*
6. Mailing Address:*
8. Mailing City, State, Zip:*
10. Phone*
11. Fax:*
13. Email:*
15. Does your business have a security alarm?*
    -- Select One --YesNO
16. Does your business have a camera system?*
    -- Select One --Yes No
18. *If yes, what areas do your cameras cover?*
    -- Select One --InsideOutsideBoth
20. AFTER HOURS CONTACT AND KEY HOLDER INFORMATION
    The Police Department keeps a list of key holders for each business in Waite Park. These people many need to be contacted after hours for numerous reasons (open door, alarm, etc). Home phone numbers are preferred. The system can only accept 3 a maximum of 3 phone numbers
22. Name:*
23. Phone:*
25. Name:*
26. Phone:*
28. Name:*
29. Phone:*
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit Submit and Print

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