This form is VOLUNTARY and the information provided will ONLY be used by the Hapeville Police Department.
Please complete this form in its entirety.

Contact Information

Type of Registry:

Business / Neighborhood / Homeowner*

Primary Contact (Name): *

Address:*

City:*

State:*

Zip:*

Phone Number:*

Alternate Phone Number:

Email Address:*

How long does system store recording?*

Number of cameras at this location? *

Describe the locations of the camera(s) (ex: south parking lot, driveway, etc.): *