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If you are planning a vacation, please use this form to request a home check from the
Elon Police Department
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Full Address
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Phone
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Email
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Date Leaving
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MM slash DD slash YYYY
Date Returning
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MM slash DD slash YYYY
Trip Destination
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Are you leaving keys with anyone?
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If yes, name?
Phone
Please list the people who should have access to the premises
Person #1
Person #2
Person #3
Person #4
Who should be contacted in the case of an emergency?
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Phone
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Do you have an alarm?
Yes
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Alarm Company
Are the lights on a timer?
Yes
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Is the house unoccupied?
Will vehicle(s) be left on the premises? If so, please list the color, make & tag number
Vehicle #1
Vehicle #2
Vehicle #3
Vehicle #4
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