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Annapolis Night Reference and Alarm Registration Form

  1. Please make sure that the location you are trying to register is located within the city boundaries. Go to the Street Listings page of the Public Works Department and check to make sure your street name and street numbers are listed.

    This form should be updated annually or when a change occurs.

  2. The address in Annapolis that you are providing night reference or alarm information for.

  3. If applicable

  4. If applicable

  5. If different from business name

  6. If different from the address above. Please include street number, street name, suite number, city, state, and zip code.

  7. Name of person completing form

  8. You can submit more than one phone number; e.g. your work phone number, cell phone number, etc.

  9. You can submit more than one email address.

  10. Emergency Contact 1

  11. Emergency Contact 2

  12. List hazardous conditions / materials, guard dogs, security personnel, weapons, directions to alarm site, etc.

  13. Do you have security cameras at this location? *

    Cameras can be inside or outside the building.

  14. If you have cameras, please include the following information about them: camera locations, type, brand, age, operating system, and retention period for the recordings.

  15. Alarm Type

    Check all that apply.

  16. For residents: enter the name of the person the alarm is registered with.
    For businesses: the name of the owner or lessee of the alarm system.

  17. Leave This Blank:

  18. This field is not part of the form submission.