Melbourne Home Page -  Police Home Page

Melbourne, Florida
Police Department Alarm Registration

Please fill-in the form completely,
then click on the 'Send' button at the bottom of the page.
Required fields are denoted with " * ".  If a required field does not pertain to your incident, please type "n/a".

**E-mail confirmation will be sent to the Primary Contact Person's e-mail address.

City of Melbourne, FL - Police Department Badge
* Today's Date: 
  
* Alarm Contract Date:  
This is the start date of the current alarm monitoring contract.
* Name of Business or Resident:    
* Business or Residence Address: 
* Suite or Apt. #:         * Zip Code:  
* Evening Phone:         * Daytime Phone:  
E-mail Address:    
    
Please complete the following contact information for your residence:
* Primary Contact Person:  
* Home Phone:     * Work Phone: 
**Email Address:      
* Second Contact Person:  
* Home Phone:     * Work Phone:  
E-mail Address:        
* Third Contact Person:  
* Home Phone:     * Work Phone:  
Email Address:        
* Name of Alarm Company:   
* Alarm Company Phone Number:  

WHEN THE FORM IS COMPLETED, CLICK ON THE 'SEND' BUTTON BELOW.
Your information will be sent to the Melbourne Police Department.