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2. First & Last Name*
3. Phone Number*
5. Address*
   Give the address of the business or home where the security camera is installed.
6. Email Address*
8. Number of Cameras*
9. Color or Black/White Footage?*
   -- Select One --ColorBlack/WhiteBoth
10. Backup/Storage*
    How many hours/days of footage is stored before it is deleted?
12. Street Coverage*
    Describe the coverage area of your cameras, including street names and directions the cameras face.
13. Camera Direction(s) (optional)

    1. North
    2. South
    3. East
    4. West
15. Do you agree to the terms & conditions?*

    The goal of the Community Security Camera Program is to deter crime and promote public safety through collaboration between the Argyle Police Department and the community we serve. Accordingly, all registrants agree to the following terms and conditions: The Argyle Police Department does not have the means or desire to take control of any citizen’s camera system. By opting into this program, the owner of any footage containing or related to criminal activity agrees to share said footage with the Argyle Police Department for use as evidence during any stage of a criminal proceeding. The Argyle Police Department may contact you directly, using the information provided on this form, to request the appropriate video footage. Video footage that is shared by the owner to social media or otherwise voluntarily placed in the public domain may be utilized by the Argyle Police Department in investigations. Under no circumstances shall registrants construe that they are acting as an agent and/or employee of the Argyle Police Department through participation in this program. Registrants may opt out of the program at any time by notifying the Argyle Police Department. Checking the "I Agree" button below indicates acceptance of the above terms and conditions.

    1. I agree
    2. I do not agree
17. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
19. Electronic Signature
Leave This Blank:


21. 1. Receive an email copy of this form.
22. Email address

    This field is not part of the form submission.

23. Submit

* indicates a required field