Security Affiliates Dealer Application
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Sign me up as a Security Affiliate!
FREE
Security Affiliates Central StationMonitoring
FREE *
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* Fill out form completely |
| Name |
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| Company Name |
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| Address |
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| City/State |
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| E-mail |
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| Phone |
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| Years in business |
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| Short description of your company. Types of services/employees, etc... |
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| * Fill out the information below |
| Total number of accounts : |
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| Average new monitored accounts/month: |
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| 800 Receiver line : |
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| Your current Central Station? |
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| Accounts going online at signup |
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| Accounts online in 6 months |
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| Insurance and Liability Information |
| Alarm Liability Insurance Company: |
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| Insurance Phone/Contact |
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| Do you have a Web site? Enter URL |
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