Police Department Business Contact Information Form
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1C
L
, N
H
ITY OF
EBANON
EW
AMPSHIRE
Police Department
BUSINESS CONTACT INFORMATION FORM
In order to better serve you, the Lebanon Public Safety Communications Division is requesting your
assistance in filling out this short contact form for your business. This information will allow us to
rapidly contact the proper representative of your business in the event of an AFTER HOURS
emergency or if there is a problem found by an officer during a routine business check.
Please return this form to the Lebanon Public Safety Communications Division – 36 Poverty Lane –
Lebanon, NH 03766. The form can also be faxed to us at 448-3315. If you prefer, give us a call at
448-1212, advise the Communication Specialist who answers your call that you would like to participate
in the Business Emergency Contact Program, and an officer will stop by and pick up your form.
Thank you for your participation.
Submit by Email
Print Form
Timothy W. Leonard, Supervisor
Communications Division
BUSINESS INFORMATION
Business Name:
_________________________________________________________________
Street Address:
___________________________________ Suite: ________________________
Business Phone:
________________________
Business Fax: ________________________
Is there any type of alarm at your business? Yes
No
Please tell us what type (i.e.: Burglary Alarm, Fire Alarm, Panic Alarm, etc.):
____________________________________________________________________________________
____________________________________________________________________________________
AFTER HOUR CONTACTS
st
1
Contact: ____________________________________ After Hours Phone #: ___________________
nd
2
Contact: ____________________________________ After Hours Phone #: ___________________
rd
3
Contact: ____________________________________ After Hours Phone #: ___________________
th
4
Contact: ____________________________________ After Hours Phone #: ___________________
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Parent category: Business