Order Form

Thank you for your interest and order.  Please fill out the information below, then submit the form.  We will send back an invoice with the total amount and necessary comments which may enhance your system.  Remember, you are under no obligation until you return the invoice form to Secure911.net.

Please enter the required quantity of components/devices below:
 
QTY Device Description - Security/Fire System
DVS-2400 DVS-2400 w/Phone Cord and Transformer
DVS-1200 DVS-1200 w/Phone Cord and Transformer
VB-2 Two-Way Voice Communication w/Voice Prompt & Remote Access
SEC-01 Additional Interior Electronic Siren
BAT-12 12VDC 24-Hour Standby Battery for Power Supply
DXS-10 Wireless Remote Keypad Control, Supervised
DXS-21 Single Channel, Hand-held Remote Transmitter
DXS-31 Door & Window Sensor w/Magnet, Supervised
DXS-54 Motion Detector - Passive Infra-Red, Supervised
DXS-72 Smoke Detector - Photoelectric, Supervised
DXS-91 Glass Breakage Detector, Supervised

 

QTY Device Description - Personal Emergency System
PERS-2400 PERS-2400 w/Phone Cord and Transformer
BAT-12 12VDC 24-Hour Standby Battery for Power Supply
VB-4 Two-Way Voice Communication & Voice Prompt
DXS-21 Single Channel, Hand-held Remote Transmitter
DXS-62 Single-Button Waterproof Wristband & Pendant Transmitter
DXS-63 Two-Button Waterproof Wristband & Pendant Transmitter
DXS-72 Smoke Detector - Photoelectric, Supervised

 

 Please enter information for the location of the new subscriber (system location):
 Name

 Last First MI  
 Address  Street Apt/Suite#
 Address             
   City 
 State & Zip  State Zip Code
 Phone No.'s  Work  Home
 FAX & E-Mail   FAX No. E-Mail
If shipping address is different, please enter information, otherwise, mark "same" for name.
 Name

 Last First MI  
 Address  Street Apt/Suite#
 Address             
   City 
 State & Zip  State Zip Code
 Phone No.'s  Work  Home
 FAX & E-Mail   FAX No. E-Mail

 If there are questions, please send us an e-mail, in addition to the order, thank you!

InfoDesk@Secure911.net

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