Business Watch Registration Form

2. Lansing Police Department Community Services Unit
   120 W. Michigan Ave Lansing MI 48933

   120 W. Michigan Ave Lansing MI 48933

4. Business Name

6. Complete Business Address (Including ZIP code)

8. Business Telephone Number

9. Fax

11. Business Owner's Name

12. Date
    Date

14. Business Owner's Home Telephone Number

15. Business Owner's Cell Phone Number

17. Business Email Address

18. Type of Business

20. Manager's Name

21. Normal Business Hours

22. Preferred Method of Contact

24. 24-Hour Emergency Contacts

26. Name

27. Telephone Number

29. Name

30. Telephone Number

32. Name

33. Telephone Number

35. Name

36. Telephone Number

38. Are there any cameras on the premise?

    1. Yes
    2. No

39. If yes, are they inside or outside

    1. Inside
    2. Outside

41. Please call the Community Services Unit at 517-377-0035 for any questions

Leave This Blank:


43. 1. Receive an email copy of this form.
44. Email address

    This field is not part of the form submission.

45. Submit

* indicates a required field