The Tech Guy http://thetechguyusa.com Wed, 18 Jan 2012 01:13:43 +0000 en hourly 1 http://wordpress.org/?v=3.3.1 Emergency Info http://thetechguyusa.com/http:/example.com/post-name/ http://thetechguyusa.com/http:/example.com/post-name/#comments Fri, 03 Dec 2010 00:02:53 +0000 admin http://thetechguyusa.com/?p=268

The Tech Guy – Edit Emergency Info


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Customer Basic Information (REQUIRED)
First Name

Last Name

Company

Customer E-Mail Address
Premise Phone #1
(

)

-

 Alarm line?
ABN (no alarm line)
Premise Phone #2, if any (

)

-

Alarm line?

Emergency Information
Abort Code
Building Type
If a business, enter name
First Name
Last Name
Address 1
Address 2
City
County
State
Zip
Other Information and/or directions
Cross Street
Customer Contact if away from premise
Work # (

)

-
Other # (

)

-
Other contact authorized to enter premise
Work # (

)

-
Other # (

)

-
Third-level Emergency Contact Name
Phone #1 (

)

-
Phone #2 (

)

-
Fourth-level Emergency Contact Name
Phone #1 (

)

-
Phone #2 (

)

-

Emergency Agency Information
Police or Sheriff Department Name
Phone
Fire Department Name
Phone
Paramedic Agency Name
Phone
VeriSign BBB OnLine


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