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2. The Vacation House Watch program allows residents within Pleasant Hill to sign up to have the police department check on your residence while on vacation or if you are going to be away from your home for an extended period of time.
   
   Fill out the form below for your home to be on the watch list.
4. First Name
5. Last Name*
7. Address1*
9. Address2
11. City*
12. State*
13. Zip*
15. Best phone number to reach you.*
17. Is your home protect by an alarm?

    1. Yes

    1. No
19. Are lights inside or outside your home on a timer?

    1. Yes

    1. No
21. Will any of your vehicles be left in the driveway during you absence? (If yes, please list them.)
23. Would you like to be contacted in the case of an emergency?

    1. Yes

    1. No
25. Best phone number to reach you at in case of an an emergency.
27. Please check my house during this time frame*
    Please check my house during this time frame Start Date

    Please check my house during this time frame Start Time

    —

    Please check my house during this time frame End Date

    Please check my house during this time frame End Time
29. Please provide any additional information you feel the police department may need.
Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field