City of Jersey Villiage - Police Department
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Jersey Village Police Department
Residents & Business Registration
Please complete the form below to receive alerts and important information
directly from the Jersey Village Police Department.

 

REGISTRATION TYPE *
Jersey Village Resident 
Jersey Village Business

CONTACT INFORMATION *
First Name: *

Last Name: *

Company Name: (if applicable)

Phone: *  (###-###-####)

Mobile Phone: (required for text alerts)

Mobile Provider:

E-mail: *

Please re-type your email address: *


ADDRESS INFORMATION
Street Address: *

Apartment / Unit #: (if applicable) 

City: *

  State: *
 Zip: *
 

PROPERTY ACCESS INFORMATION
Gate / Access Code (if applicable)


PROPERTY OWNER INFORMATION
IF DIFFERENT FROM ABOVE
(Name, Address, Phone, Email Address)


EMERGENCY CONTACTS
Names / phone numbers



HOUSEHOLD OCCUPANT SPECIFIC NEEDS
(if applicable)
Disabled Special Needs/Other
(describe below)


WEBSITE ACCESS / PASSWORD
Create a password access your account: *
Minimum 5 characters; 1 numeric

 

NOTIFICATION PREFERENCES
Email Alerts from JVPD 
Text Alerts from JVPD
I do not want to receive any alerts


NO SOLICITING
Do you want to be on the no solicitors list? *
Yes No  N/A

ALARM SYSTEM *
YesNo

TYPE OF ALARM  *
Burglary Fire Both  N/A

ALARM INFORMATION
Alarm Company Name:

Alarm Company Phone Number:


ALARM EMERGENCY CONTACTS
List two people who are to be notified, in your absence, in the event of an activated alarm.  These contact persons should respond to the alarm site within one hour and grant access to location.  If necessary they should be able to deactivate alarm.
 Click here if same as Emergency Contacts
Name / Phones Numbers:

ANIMALS
Are there any animals on the property? *
Yes No
Describe below: Number, Type, Indoor/Outdoor



VIDEO SECURITY
Do you have a video security system? 
Yes No

What type of coverage does it provide? 
Interior Exterior  Both

Does your system record? 
YesNo 

Are you willing to share this video with law enforcement to help solve a crime? 
YesNo 

This information will be sent directly to the Jersey Village Police Department and will not be shared.

 

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