Apply for membership | WEPROTECT TASK FORCE

First and last name of member 1 (referring you to our private protection network)*

First and last name of member 2 (referring you to our private protection network)*

Your first and last name*

Your home address*

Postal code*

Mobile Phone Number*

Home phone number

E-mail*

Do you have an alarm system on site?*

Yes

No

Brand of on-site alarm system*

Number of contact points*

Do you have a video surveillance system on site?*

Yes

No

Make of the video surveillance system on site?*

Number of cameras*

How many hours a day is your home unoccupied?*

It is almost never unoccupied

Less than 2 hours per day

Between 2 and 5 hours per day

More than 5 hours per day

Number of adults in the home*

Number of children in the home*

Age of children in the home (Enter a number between 1 and 17)*

Please enter a number from 1 to 17.

First and last name of contact 1*

Mobile number of contact 1*

First and last name of contact 2*

Mobile number of contact 2*

Name

This field is for validation purposes and should be left unchanged.

Apply for membership.