New Customer Application

First Name *
Last Name *
Phone Number *(Area Code) 555-1234
E-mail Address *
Address of The Site That Needs Service *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Type of Service *(special event, patrol, dedicated patrol, unarmed officer(s), armed officer(s), other)
When do you need this service to begin? *
Hours per day and days of the week for service? *(e.g. 8 hours per day, Monday – Friday)
Any Special Requirements? (e.g. check IDs, monitor cameras or gages, HAZCOM training, language(s), issue parking citations, CPR & AED training)
Who referred you to us?