PRODUCT REGISTRATION TRANSFER
DISCLOSURE OF INFORMATION: 911alertec will not sell, trade, rent or release such information to entities outside of the 911alertec family of companies.
Please Type or Check Off Information in Boxes Provided
Enter the five (5) digit code provided on Product Registration card
Your telephone number with area code will be used as your ID-Code
Name or place of business
Address or Location
Address (additional if needed)
City, Town or Village
State or Province
Zip or Postal Code
Date product was purchased Date/Month/Year ?
How did you come to know about our product ?
How many people including yourself are at your location ?
Our product will be installed in your (please check appropriate box)
Number of same products purchased for same location for example
- some purchasers have installed product at front and rear door
If purchased for use in a housing project - number of units installed
