Form Center

2. The ordinance requires businesses and residential alarm users to register their systems with the town.
   
   For additional information regarding the Town Ordinance for Emergency Alarm Systems please visit https://ecode360.com/33919124.
   
   Yearly renewal - $25.00

6. Westfield Alarm Number*
8. Name or Business Name*
10. Street Address (in Westfield)*
12. Phone Number*
14. Email Address*
16. Is ALL of your information correct on your letter?

    1. Yes
    2. No
18. Optional Information
20. If no, what information do you need to update?

    1. Alarm Company Information
    2. Billing Information
    3. Emergency Contact #1
    4. Emergency Contact #2
    5. Emergency Contact #3
    6. Owner Contact Information
22. Owner #1 Name*
23. Owner #1 Phone*
24. Owner #1 Email Address*
26. Owner #2 Name
27. Owner #2 Phone
28. Owner #2 Email Address
30. Billing Address*
31. Billing City*
32. Billing State*
    -- Select One --NJ - New JerseyAK - AlaskaAL - AlabamaAR - ArkansasAZ - ArizonaCA - CaliforniaCO - ColoradoCT - ConnecticutDE - DelawareFL - FloridaGA - GeorgiaHI - HawaiiIA - IowaID - IdahoIL - IllinoisIN - IndianaKS - KansasKY - KentuckyLA - LouisianaMA - MassachusettsMD - MarylandME - MaineMI - MichiganMN - MinnesotaMO - MissouriMS - MississippiMT - MontanaNC - North CarolinaND - North DakotaNE - NebraskaNH - New HampshireNM - New MexicoNV - NevadaNY - New YorkOH - OhioOK - OklahomaOR - OregonPA - PennsylvaniaRI - Rhode IslandSC - South CarolinaSD - South DakotaTN - TennesseeTX - TexasUT - UtahVA - VirginiaVT - VermontWA - WashingtonWI - WisconsinWV - West VirginiaWY - WyomingOther - Non US
33. Billing Zip Code*
35. Alarm Company Name*
36. Alarm Company Telephone Number*
38. Do you want to Delete or Update Emergency Contact #1?*

    1. Delete
    2. Update
40. Emergency Contact #1 Name*
41. Emergency Contact #1 Phone #1*
42. Emergency Contact #1 Phone #2
44. Do you want to Delete or Update Emergency Contact #2?*

    1. Delete
    2. Update
46. Emergency Contact #2 Name*
47. Emergency Contact #2 Phone #1*
48. Emergency Contact #2 Phone #2
50. Do you want to Delete or Update Emergency Contact #3?*

    1. Delete
    2. Update
52. Emergency Contact #3 Name*
53. Emergency Contact #3 Phone #1*
54. Emergency Contact #3 Phone #2
56. Alarm Fee
    Alarm Renewal
57. Price
58. Quantity
59. Shipping Cost
61. Taxable
Leave This Blank:


62. Calculate Totals Proceed to Checkout

* indicates a required field