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mission statement
PRODUCT REGISTRATION
DISCLOSURE OF INFORMATION: 911alertec will not sell, trade, rent or release such information to entities outside of the 911alertec family of companies.
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Please Type or Check Off Information in Boxes Provided
From the drop-down menu - choose the type of switch purchased
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
