The Dudley Police Department is updating our computer information. Supplying the following information will greatly enhance the response of the police and fire departments in the event that your alarm signifies a problem. Please complete this form and return it to:

Dudley Police Department

71 West Main St.

Dudley, MA 01571

Attn: Officer Philip Megas

Alarm system is capable of summoning ____Police ____Fire _____Both ____Audible Alarm Only

Alarm Info:               Company                   _________________________________

Address                     _________________________________

Phone Number          _________________________________

Residence Info:                  Address                     _________________________________

Mailing (if different)   _________________________________

Owner(s)                    _________________________________

Telephone Number   _________________________________

Cell Number               _________________________________

Other # (work, etc)    _________________________________

Pets (optional)           _________________________________

                     In the event that my alarm sounds, please contact the following person(s).

1.         Name              ____________________________________

Address          ____________________________________

Home Phone  ____________________________________

Work Phone   ____________________________________

Cell Phone      ____________________________________  

            2.         Name              ____________________________________

Address          ____________________________________

Home Phone  ____________________________________

Work Phone   ____________________________________

Cell Phone      ____________________________________

Additional comments/concerns:  _____________________________________________________ ______________________________________________________________________________

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