Form Testing 2 - Bloomfield Township

Bloomfield Township Police Department Emergency Contact Information

Please notify us if there is any change in the information by re-submitting this form, or if you have questions. Dispatch Supervisor: 248-642-7659.

Name of Business *

Street Address *

Suite Number

Business Phone *

Alternate Phone

Name of Business Owner *

Business Owner Home Phone *

Cell *

Business Owner Email Address *

Person(s) to Contact in Case of Emergency

(We will contact in this order, if possible, until contact is made)

Name 1 *

Title 1 *

Phone 1 *

Cell 1

Name 2 *

Title 2 *

Phone 2 *

Cell 2

Name 3

Title 3

Phone 3

Cell 3

Property Management Company (if applicable)

Property Management Business Phone

After Hours Phone

Alarm Company

Phone Number

Does the business have video surveillance? *

Yes

No

Have you enrolled your video surveillance system in the Bloomfield Township Police Department's Extra Eyes program? *

Yes

No

The Extra Eyes program allows residents and businesses to register their video surveillance systems to help the Bloomfield Township Police Department locate possible video evidence after a crime has been committed.

To register your surveillance system, download and complete the Extra Eyes Registration Form.

Additional Information