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2. First Name*
3. Last Name*
5. Business Name
7. Address*
9. City*
10. State*
11. Zip Code*
13. Phone Number*
14. Alternate Phone Number
16. Email Address
18. HOA/Neighborhood
20. Video System Make*
22. Video System Model*
24. Number of Cameras*

    1. 1
    2. 2
    3. 3
    4. 4
    5. 5+
25. Do the cameras have night vision or infrared capabilities?*

    1. Yes
    2. No
26. Video is:*

    1. Always On
    2. Motion Activated
27. Do the cameras film in color?*

    1. Yes
    2. No
29. Camera Views*

    1. Alley
    2. Back Door
    3. Back Yard
    4. Drive Way
    5. East Side of House
    6. Front Door
    7. Front Yard
    8. Hallway
    9. Lobby

    1. North Side of House
    2. Parking Lot
    3. Patio
    4. Room/Office
    5. South Side of House
    6. Street
    7. West Side of House
    8. Other
31. If you selected other, please explain
33. How long is recorded video kept before deletion?*
35. Additional Information

37. Thank you for your participation. In the event a crime has been committed in your neighborhood, a Justin Police Officer or Detective may contact you and request to view your video recordings. If you have changes to the information or wish to be removed, please contact our office at 940-648-2541.

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39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit

* indicates a required field