PARK GLEN/PID 6 PUBLIC SAFETY
VACATION WATCH PROGRAM
This form is used to notify the PID6 Patrol Officers, FWPD, of your upcoming vacation.  The officers cannot guarantee that they will be able to check your residence at specific times or dates, but they will however make every effort to make as many checks on your residence as time and workload permit.

Please complete all areas of this form and email it to Lt. Jon Grady at pid6patrol@aol.com.  You can save this form to your PC (click File then Save As) so it will be available to you whenever you need it.  

Please remember to contact Lt. Grady at 817-994-3834 if you return early from your vacation or if your departure or return times change

Name:

Address:

Your house is:  North of Basswood ___	South of Basswood   ___
		East of Park Vista    ___	West of Park Vista    ___ 
		East of Beach	         ___	South of N Tarrant    ___
Please place an “X” by the appropriate location.

E-Mail:

Home Phone:

Away Phone::(Where you can be reached while away)

Date/Time Departure:				Date/Time Return:

Local Emergency Contact:

Name:
Address:
Phone:				Do they have a key?  Yes ___     No ___






Persons Authorized on Property (Lawn/Pet care, etc.):

Name:
Name:
Name:
Name:

Vehicles Left on Property (DO NOT INCLUDE VEHICLES IN GARAGE):

Year:			Make:   		Model:		Color:		Lic/State:

Year:			Make:   		Model:		Color:		Lic/State:


Please Answer Yes or No to the Following:

Alarm system?    Yes   ___   No   ____       Alarm Co and Phone:
System On?          Yes   ___  No   ____

Broken Windows, Screens, Fence, Doors?  Yes ___   No  ___      Where?

Lights left on?  Yes ___    No  ___      Where?

Pets in yard?      Yes ___   No  ___       What type?                                 How many?

Paper/mail stopped?    Yes  ___  No  ____

Member of Neighborhood Crime Watch?    Yes ___    No ___

Additional Information:







Park Glen/PID 6 Public Safety
Vacation Watch Program
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©2003