Forms • Bloomfield Hills, MI • CivicEngage

Camera Registry

Leave This Blank:

First Name:*

Last Name:*

Street Address:*

City*

State:*

ZIP:*

Phone Number:*

Email:*

Residential or Business?*

Residential

Commercial

Business Name (if applicable)?

Length of Time Stored (i.e. 1 month, 2 weeks, 7 days etc.):

Camera Brand(s):

Cloud or Internal/Onsite DVR:

Number of Cameras?*

What areas do your cameras cover? (Example: Front Yard, Back Yard, etc.):

What Streets do your Cameras Cover?

Ability to Email, Thumb Drive, or Other Method of Providing Material:

Other Comments:

* indicates required fields.