Warwickshire Police

COMMUNITY ALERTS ONLINE FORM

Data Protection Act and Telecommunications Act Authorisation Form

I would like to receive Community Alert Messages via email. My details are:

Forename

Surname

Address

Post Code

Email

Alternatively we can provide the Community Alert messages via the following channels - please complete as necessary.

Fax

Mobile

Telephone

Telephone Only: Please provide us with times when you wish to receive a call (between x and y)

1. I give Warwickshire Police the authority to place my details on a computerised database. I understand that the system is registered under the Data Protection Act and that my rights are protected.

I Agree

2. I agree to receive automated messages by the means selected above generated by the Warwickshire Police Watch messaging system.

I Agree

3. I would like to join the Neighbourhood Watch scheme in my road or area.

Please tick

4. I would like to set up a Neighbourhood Watch scheme in my road or area if one does not exist.

Please tick

If you would like to receive a response to indicate we have successfully received your submission, please enter a valid email address below: