24-Hour Monitoring Registration | Premier Communications

Subscriber Information
Subscriber Contact Name*
Email*
Business Name/Subscriber Name*
Address*
Street Address Address Line 2 City State ZIP Code
Primary Phone*
Secondary Phone
System Information
Monitor Start Date
MM slash DD slash YYYY
Police / City Permit #
Manufacturer of Existing Security System
Special Instructions
Notification Information
Call at least this many people from the list below:*
Parties will be called in sequence until the number of parties in the box above have been reached.
Party 1 Name*
Party 1 Comment
Party 1 Name*
- Add another Party?
Party 2 Name*
Party 2 Phone*
Party 2 Comment
- Add another Party?
Party 3 Name*
Party 3 Phone*
Party 3 Comment
- Add another Party?
Party 4 Name*
Party 4 Phone*
Party 4 Comment
- Add another Party?
Party 5 Name*
Party 5 Phone*
Party 5 Comment
- Add another Party?
Party 6 Phone*
Party 6 Name*
Party 6 Comment
List additional parties in order:
Emergency Services
Police Department*
Police Primary Phone*
Police Secondary Phone
Fire Department*
Fire Primary Phone*
Fire Secondary Phone
Medical Contract
Medical Primary Phone
Medical Secondary Phone
Other
Other Primary Phone
Other Secondary Phone
Commercial Accounts Alarm Verification
Instructions: Please list your hours of operations. We will verify alarms with you during these hours. For each day, please enter a range of hours (e.g. 9:00am - 5:00pm) or "Closed"
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Human Verification
Please enter any two digits with no spaces (Example: 12)*

Subscriber Information