In an effort to better serve you we continuously update our department files, including all emergency contact information for commercial businesses in the town of Holland. The purpose of having this information is so that we can contact you or your selected representative in case an emergency situation or an incident involving the police department arises at your business after hours of operation. The information that you provide us will be entered into our department computer system as emergency contact information and not decimated to the public, however a copy of the
information will be forwarded to our dispatch center (New Braintree Regional Dispatch) for their records.
Business Name: _______________________________________________________________________
Street Address: ________________________________________________________________________
Business Phone: _______________________________________________________________________
Fire Alarm YES / NO Burglar Alarm YES / NO
Name of alarm company: ___________________________
(If applicable)
Phone Number: ___________________________
(If applicable)
Primary Contact: _____________________________ Title:_____________________________
Home Address: _________________________________
City/State/Zip: _________________________________
Home Phone: _________________________________
Cell/Work/Pager: _________________________________
Alternate Contact: _____________________________ Title:_____________________________
Home Address: _________________________________
City/State/Zip: _________________________________
Home Phone: _________________________________
Cell/Work/Pager: _________________________________
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