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VACANT HOUSE/EMERGENCY CONTACT FORM Updated June 16, 2006
 

The Highland Park Police Department maintains a data base of contacts for out of town residents. The data base is utilized by both Police and Fire Departments to assist in contacting owners and/or caretakers in the event of an emergency.

Residents can submit their information either by this online form or by contacting the Police Department at (847) 432-7730.

OWNER:  
Name:
   
Email Address:
   
Address:
   
Phone Number:
   
Cellular Number:
   
Dates Away: to
   
KEYHOLDERS:  
Name: Phone:
Name: Phone:
 
EMERGENCY CONTACT NUMBER FOR OWNER:
   

Other Information:

Lights on timers at residence?
Will there be cars in the driveway?
Alarm system utilized at residence?