CRM Lead Form | Citizen Surveillance Network

WhatsApp Number

Same as Above
Don't Use WhatsApp
Other

Addons per camera /Monthly

30 Min Battery Backup ($50)
Next Day Camera Check ($50)

Privacy Settings*

Permission Given to share FULL VIDEO with Security Agencies (TTPS, TTMPS MNS)
Please BLUR Live Video for privacy

Internet Provider*

Ampila Digicel
Flow Other
No Internet Connection

Neighbours Sharing With

Do you have other neighbours who will join with you or may be interested that you think we should call?

Enter neighbour #1 name

Enter neighbour #1 telephone number

Enter neighbour #2 name

Enter neighbour #2 telephone number

How did you hear about us?

Television News Personal Contact
Neighbour Sales Rep
Social Media Police Officer
Community Meeting
Other

Requirements from Customer

Suitable location to install camera

110v AC Supply

Internet Access

Provide Router Password

Notify us of any Network Changes

Minimum Contract Period – 6 Months

The customer agrees that Citizen Surveillance Network and its affiliates Ultimate Solutions Ltd will NOT be held liable for video loss regardless of reason. This includes Force Majeure, camera failure, Recording failure or Network Failure.