City of Oconomowoc Police & Fire Night Number Listing

2. City of Oconomowoc Police and Fire Departments Night Number Listing

4. Name of Business:*

6. Web Site Address for Business:

8. Address1

10. City

11. State

12. Zip

14. Phone Number of Business:*

15. Alarm System:*
    -- Select One --BurglarHold-UpFireNoneSilentAudio

    Please Select what type of Alarm you have and if it is silent or audio

17. Days of Operation:*

    1. M-F
    2. SAT
    3. SUN

18. Hours of Operation MON-FRI

19. Hours of Operation SAT:

20. Hours of Operation SUN:

22. Name of Alarm Company:

23. Phone #:

25. Address of Alarm Company

27. City

28. State

29. Zip

31. Business Owners Name:

33. Owners Address:

35. City

36. State

37. Zip

41. Manager's Information:
    Complete the below listed information for Manager and Assistant Manger of Business.

    Complete the below listed information for Manager and Assistant Manger of Business.

43. Home Phone #:

44. Cell Phone #:

45. Alternate Phone #:

47. Name:

49. Address:

51. City

52. State

53. Zip

57. Assistant Manager's Name:

59. Home Phone #:

60. Cell Phone #:

61. Alternate Phone #:

65. List below the order in which you want calls to be placed:

67. First To Be Called

68. Phone #:

70. Second To Be Called

71. Phone #:

73. Last To Be Called

74. Phone #:

Leave This Blank:


76. 1. Receive an email copy of this form.
77. Email address

    This field is not part of the form submission.

78. Submit Submit and Print

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