Dealer Submission Form | Towne Services

Please take a few minutes and fill out this form so that we can get started programming your Elevator Monitoring account! Please provide as much information as possible. We will review your document after its submitted and contact you if we have any questions.

Important note: Aside from the information regarding the elevator(s) to be monitored, you will need the following information to complete this form:

- Names and Phone numbers of any appropriate
contacts.

- What does your elevator equipment do when activated? (Hint: Some units play a recording, some units have prompts to be followed, some simply connect the elevator caller to our operator, etc.)

Once you complete this form, your completed information will be sent to us and a copy will be sent to you as well. Should you have any questions, please feel free to contact us and we will be glad to help you through this process.

Is this a Continuing Submission?

First, please tell us about the person submitting this form and the business/building where the elevators are to be monitored.

Person Submitting this Form:

Work Phone

Cell Phone (Opt)

Your email address

Name of Business/Building:

On Site Emergency Contact (Name & Number, if none available indicate that here):

Complete Address (Street, City, State, Zip):

Are there any issues that we should be aware of regarding the account?

Next we will gather details on the elevator(s) that you would like us to monitor. This form accommodates up to 6 elevators. If more are needed, simply submit a second form marking it as a Continuing Submission at the top and selecting None for contacts below, and we will contact you regarding your final pricing.

How many elevators would you like to have monitored?

Payment Information

Elevator Name and/or Number:

Caller ID

Location (as detailed as need be) (Include video ID if applicable)

Elevator 2 Name and/or Number:

Caller ID

Location (as detailed as need be) (Include video ID if applicable)

Elevator 3 Name and/or Number:

Caller ID

Location (as detailed as need be) (Include video ID if applicable)

Elevator 4 Name and/or Number:

Caller ID

Location (as detailed as need be) (Include video ID if applicable)

Elevator 5 Name and/or Number:

Caller ID

Location (as detailed as need be) (Include video ID if applicable)

Elevator 6 Name and/or Number:

Caller ID

Location (as detailed as need be) (Include video ID if applicable)

OK - now we'll gather information about who to reach and any other information you think we would need.

If this is a continuing submission please leave set to 'None'.

How many points of contact do you want?

Contact #1

Phone Number

Contact #2

Phone Number

Contact #3

Phone Number

Contact #4

Phone Number

Elevator Service Company

Phone Number

Are there any special notes or instructions?

That's it , you've finished!

Below you will see our Elevator Monitoring agreement. This form, along with the answers that you've given above, will be sent to the email address that you provided above as record of completion. Upon review from our programmers, we will contact you with any questions we may have and to arrange payment.

Thank you for choosing Towne - We look forward to serving you.