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2. 
4. Civic Association Name / Neighborhood*
6. Primary Contact (Captain)
8. First Name
9. Last Name

11. If your address changes or if another member is elected as Captain, please inform your UPD Community Policing Unit by email (UPD-NHW@uniontownship.com) or call 908-851-5252

13. Address
15. City
16. State
17. Zip
19. Cell Phone*
20. Home Phone*
22. Email*
24. Neighborhood Information
26. Name of Neighborhood Watch Group:*
27. Date Neighborhood Watch Group started *
29. Number of members *
30. Current greatest crime/threat issue in your neighborhood? :*
32. What blocks, parks, schools, streets, parking lots, condo complex, does your Neighborhood Watch cover? *
34. Is there a request for individual Crime Prevention Home Survey? *

    1. Yes
    2. No
36. Request for Neighborhood Watch Signage
38. Request for Neighborhood Watch Signage*

    1. We are requesting Neighborhood Watch street and window signs.
    2. We currently have old signage that needs to be replaced.
    3. We do not currently have any Neighborhood Watch Signs.
40. If you selected to request a sign or currently have a sign. Please fill out below.

    Please indicate how many signs you are requesting or please let us know the location of the old signage that needs to be replaced. 

42. Important: The Watch Captain has NO legal authority on behalf of the Union Police Department. It is emphasized that “captains” and all participants limit their participation to observations and reporting to the police department. At no time should anyone become physically involved in any situation that may endanger them or another person. This includes, but is not limited to investigating suspicious occurrences or apprehending a criminal.

44. Signature*
Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit

* indicates a required field