Fire Dept Registration Form

Emergency Access Systems, INC. P.O Box 1811 Kingston, RI 02881 | Telephone: 401-295-7707 Fax: 401-295-7708 | Toll Free: 877-562-5269

Date

format mm/dd/yyyy
Fire Department Name & Address*
Fire Department Mailing Address (If different from above)
Chief of Department*
Phone
Fax
EAS Official Contact
Title*
Name*
Authorized Signature List*

In order to insure the highest level of security, only persons listed below will be authorized to add or remove signatures and order keys.
( Please list in the following format - Date | Name | Title )
We recommend having one extra key on hand for emergency use. However, it should be secured in the fire department's vault or safety deposit box at all times.
Will your fire department be sharing this system with any other department? If so, please list all department names below.

EAS Official Contact