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*Required information.

This report is for members of the community to inform the Elon Police Department of an upcoming vacation.

Name *
Full Address *
Phone *
E-mail *
Date Leaving
Date Returning
Trip Destination
Are you leaving a set of keys with anyone?
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?

Will the lights be turned on?
Do you have an alarm?
Alarm Company
Are the lights on a timer?
Is the house unoccupied?

Will vehicle(s) be left on the premises? If so, please list the color, make & tag #

Vehicle #1
Vehicle #2
Vehicle #3
Vehicle #4