Form Testing 2 - Bloomfield Township

Bloomfield Township Police Department Emergency Contact Information

Please notify us if there is any change in the information by re-submitting this form, or if you have questions. Dispatch Supervisor: 248-642-7659.

Name of Business *

Street Address *

Business Phone *

Alternate Phone

Name of Business Owner *

Business Owner Home Phone

Cell

Business Owner Email Address *

Person(s) to Contact in Case of Emergency

(We will contact in this order, if possible, until contact is made)

Name 1 *

Title 1 *

Phone 1 *

Cell 1

Name 2 *

Title 2 *

Phone 2 *

Cell 2

Name 3 *

Title 3 *

Phone 3 *

Cell 3 *

Property Management Company (if applicable)

Property Management Business Phone *

After Hours Phone

Alarm Company

Phone Number

Additional Information