Emergency Contact Form

You can fill out this on line Emergency Contact List form at your own convenience . This form is used in the event there is an alarm activation or emergency at your business or residence. If you would rather call, please contact the General Police Information Desk at 518-783-2744 and a telecommunicator will assist you. You can also fill out this form on line, press the print button at the bottom of the page and mail it to:

Colonie Police Department
Communications Division
312 Wolf Rd.
Latham, NY 12110

* These fields are required in order to process your request.

Personal Details Buisness Name

Last Name

First Name

Address

City

Zip Code

Phone Number

E-Mail Address

PERSONS TO BE CONTACTED IN CASE OF AN EMERGENCY.
Only one name is required. Additional names will be contacted if the first is unavailable.

Emergency Contact 1 Information Contact 1 Name

Contact 1 Address

Contact 1 City

Contact 1 Zip Code

Contact 1 Phone Number

Emergency Contact 2 Information Contact 2 Name

Contact 2 Address

Contact 2 City

Contact 2 Zip Code

Contact 2 Phone Number

Emergency Contacts 3 Information Contact 3 Name

Contact 3 Address

Contact 3 City

Contact 3 Zip Code

Contact 3 Phone Number

Comments

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Emergency Contact Form