PLEASE WATCH MY HOUSE!
	NEIGHBORHOOD WATCH VACATION/TRIP INFORMATION
	GIVE TO BLOCK CAPTAIN AND NEIGHBORS (Please Print)
Resident's Name:__________________________ Address:______________________________________ Date Leaving:_____________                    Date Returning:_____________ In the event of an emergency, where can you be contacted?                   From__________  To__________  Name__________________  Phone_____________                    From__________  To__________  Name__________________  Phone_____________ Does anyone have a key to your house?_____  If so, who?_________________________________ Security System?  Yes___No___  If yes, who has the alarm code?__________________________ Are you expecting any visitors while gone?  Yes_____  No_____ If yes, what date(s)?_____________ Make/color of car they drive:__________________ Do you have interior lights on a timer?   Yes___No___ If yes, what rooms and what times on and off?______________________________________________________ Are there any pets in the house?   Yes___No___ If yes, what type, how many and where?_______________________________________ Will paper continue to be delivered?   Yes___No___(If yes, please make arrangements for neighbor to pick up.)