CPTED Mini-Grant Application

CPTED Location * Required
Street Address Address Line 2 City State ZIP Code
Primary Contact * Required
First Last
Company * Required
Address * Required
Street Address Address Line 2 City State ZIP Code
Business Phone * Required
Cell Phone * Required
Email * Required
Owner of property if different from above
First Last
If surveillance cameras are going to be installed, does the above primary point of contact have control to view the video or will this be accessed by someone else? If "no", explain. * Required
- No
- Yes
Has your property been directly impacted by illegal dumping in the past? Please describe. * Required
What will the grant be used for? * Required
Surveillance cameras, lighting, etc. Please provide as much detail as possible regarding the type, make, and model of all equipment, lights or other Crime Prevention Through Environmental Design equipment/materials to be purchased. In addition to a written description, please provide photographs or other material to support your application.
File/Photo File upload
File/Photo File upload
File/Photo File upload
File/Photo File upload
File/Photo File upload
File/Photo File upload