Marengo County Emergency Communications District

Name of person who filled out form

When you have completed this form please click on submit

Phone number of person who filled out form

Business Hours

Email:

Phone

Name of keyholder # 1

If you have a picture of the business/school please send it to us.

Do you have an alarm company?

Yes

No

Name of keyholder # 2

This section has been established to streamline the process for residences, businesses, schools, and other facilities to register their emergency contact and key holder information with the 9-1-1 system.

The information submitted will be made available to local law enforcement and emergency service agencies in the event of an incident requiring notification of a responsible party. It may also be used to distribute important safety alerts or critical updates when appropriate.

We respectfully ask that you complete and submit the form below to ensure your contact information is accurate and current.

Maintaining up-to-date records enables emergency responders to act quickly, efficiently, and effectively when it matters most.

Thank you for your cooperation and commitment to public safety.

Alarm Company Phone Number

Address

Business Name

Alarm Company Name

Phone number of keyholder # 2

Phone number of keyholder # 1

Resident Name

Register Your Contact & Key Holder Information