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Vacation Home Check Program Application

2. The Vacation Home Check patrols are conducted by members of the Volunteers in Policing Program (VIPs)

   Checks are limited to front and side yards

   Please complete the information requested below

   The form must be completed and submitted a minimum of 5 days prior to departure

4. Resident Name:*

6. Address:*

8. City:*

10. State:*

12. Zip:*

14. Email:*

16. Home Phone:*

18. Cell Phone:*

20. Date of Departure:
    mm/dd/yy*

22. Date of Return:
    mm/dd/yy*

24. Local Emergency Contact Name:*

26. Local Emergency Contact Phone:*

28. Local Emergency Contact Email:

30. Address:*

32. City:*

34. State:*

36. Zip:*

38. Emergency Contact has keys?*
    -- Select One --YesNo

40. Vehicle(s) Left on Property?*
    -- Select One --YesNo

42. Make/Model

44. Year

46. Vehicle(s) Left on Property
    -- Select One --YesNo

48. Make/Model:

50. Year:

52. Persons Authorized on Property:
    (lawn/pet care)

54. Lights Left on Timer*
    -- Select One --YesNo

56. Animals in Home or Backyard?*
    -- Select One --YesNo

58. Is House Alarmed?*
    -- Select One --YesNo

60. If Yes, Type of Alarm:

    1. Audible
    2. Silent

62. Name of Alarm Company:

64. Anyone Checking on Home?*
    -- Select One --YesNo

66. If Yes, Please Provide Name:

68. Contact Phone Number:

70. Please Provide Any Additional Information in Space Provided:

72. I understand the Vacation Home Check Program will be conducted as time permits by members of the Volunteers in Policing Program. <br><br>By submitting this form I release the City of Morgan Hill Police Department of all liability for any loss or property damage occurring during this time period.

    I understand the Vacation Home Check Program will be conducted as time permits by members of the Volunteers in Policing Program.
    
    By submitting this form I release the City of Morgan Hill Police Department of all liability for any loss or property damage occurring during this time period.

Leave This Blank:


74. 1. Receive an email copy of this form.
75. Email address

    This field is not part of the form submission.

76. Submit Submit and Print

* indicates a required field