Connect New York - Camera Integration Submission Form

Connect New York - Camera Integration Submission Form

Business Name*

Business Point of Contact - First Name*

Business Point of Contact - Last Name*

Business Point of Contact - Email*

Please provide the best email address to contact.

Business Point of Contact - Phone Number*

Please provide the best phone number to contact.

Phone

IT Point of Contact - First Name

If applicable.

IT Point of Contact - Last Name

If applicable.

IT Point of Contact - Email

If applicable.

IT Point of Contact - Phone Number

If applicable.

Phone

Preferred Language

Street Address*

Please provide the address of business.

City*

State/Region*

Postal Code*

Does the Location Have Internet?*

An internet connection is required to participate.

Select or enter value

Does the Location Have an Existing Camera System?*

A camera system is required to participate.

Select or enter value

If "Yes", please specify the make and model.

The make and model sticker can be located on the back and/or sides of the DVR/NVR.

DVR | NVR Photos?

Drag and drop files here or

Do you have access to the credentials of your existing camera system?*

Please have the credentials available for the day of installation or you may provide them below.

Select or enter value

Username

Password

Number of External Camera Feeds?

Number of Internal Camera Feeds?

Availability*

Select or enter value

Additional Notes

By checking this box, I am agreeing to participating in the Connect New York program.*

Send me a copy of my responses