The Police Department in Little Elm is committed to the safety and protection of its business community. Please take a moment to partner with us by completing and submitting this important enrollment form.

Today's date: (enter as mm/dd/yyyy)*

Is this a new or updated enrollment?*

New

Update

Business Information

Name of Business:*

Street Address:*

City:*

State:*

Zip:*

Mailing Address (if different from Street Address):

City:

State:

Zip:

Phone Number: entry format (123) 456-7890*

Fax Number: entry format (123) 456-7890

Business Web Site (if any):

Business Email Address (if any):

Primary Business Contact Person

Persons Name:*

Title (Owner, Manager, President, etc.):*

Emergency Phone Number:
entry format (123) 456-7890*

Number is the persons:*

Home Cell

Other

Alternate Phone Number:
entry format (123) 456-7890

Number is the persons:

Home Cell

Other

Personal E-Mail address:

Alternate Business Contact Person

Persons Name:

Title (Owner, Manager, President, etc.):

Emergency Phone Number:
entry format (123) 456-7890

Number is the persons:

Home Cell

Other

Alternate Phone Number:
entry format (123) 456-7890

Number is the persons:

Home Cell

Other

Personal E-Mail Address:

Alarm and Utility Contact Information

Do you have a burglar alarm at your business?*

Yes

No

What is the name of the alarm company who monitors it?
(If none, write N/A)

What is your city alarm permit number?
(If none, write N/A)

NOTE: Town Ordinance #730 requires anyone who has an alarm to have a permit. If you have an alarm, but do NOT have a permit, the Alarm Permit Form needs to be completed.

Read the alarm permit guidelines here

Alarm Permit Guidelines

Print the Alarm Permit

Alarm Permit

What is the 24 hour phone number of the alarm monitoring company?

What is the name of the electric company that services your business?

If you have been given an emergency contact number for them, please list it here.

What is the name of the gas company that services your business?

If you have been given an emergency contact number for them, please list it here.

List any additional, relevant information here.

Thank You