1. Is you home already
equipped with a security system?
If yes, is the system
currently monitored?
If yes, what brand of system
do you have?
ADT
Other
2. Are you
3. How many adults in your
household, including yourself
4. Are there children
living in your home? (ADT has security products
specifically for homes with children)
No
5. Are there any indoor
pets in your family?
6. What is the occupation
of the head of the household?
Administrative/Managerial
Clerical
Craftsman
Farmer
Military
Professional/Technical
Religious
Retired
Sales/Service
Student
Other
7. Does your occupation
require you to travel, taking you away from your home
and family?
8. Is your home under
construction?
9. Is your home pre-wired
for a security system?
10. What type of home do
you live in?
Single Family
Townhouse
Condominium
Apartment
11. Do you own or rent your
home?
12. If you own your home,
what is the approximate value of your home?
Less than $50,000
$50,000 - $74,900
$75,000 - $99,999
$100,000 - $124,900
$125,000 - $200,000
More than $200,000
13. How long have you lived
at your current residence?
14. How many bedrooms do
you have?
One
Two
Three
Four
Five or more
15. What is the square
footage of your home?
Under 1,000 sq. ft.
1,000 - 2,900 sq. ft.
2,901 - 3,499 sq. ft.
3,500 or more sq. ft.
16. What type of foundation
is your home built on?
Slab
Crawl space
Unfinished basement
Finished basement
Don't know
17. What type of attic do
you have?
None
Unfinished attic
Finished attic
Don't know
18. How many doors do you
have that lead to the outside, including the entry door
from the garage?
19. Enter the number of
vulnerable windows you have. Typically the most
vulnerable windows are windows that are accessible from
the ground level, second floor windows that are
accessible from a low lying roof line or outside
balconies, or decks.
20. Enter the number of
additional motion sensors you would like to add to your
security system. You can also use interior motion
sensors placed in strategic traffic areas throughout the
house. You will get one motion sensor with a basic ADT
Security System.
21. Add the number of smoke
detectors you feel will help protect your home.
Protecting your family against fire is one of the most
important security decisions you will make. By choosing
monitored fire protection, your system can call for
help. ADT recommend one monitored smoke detector per
floor for minimum protection. Additional smoke
detectors are also recommended in the vicinity of each
bedroom.
22. Would you like to add
monitored carbon monoxide protection to your system? If
you have an attached garage, gas log fireplace or other
appliances that might generate carbon monoxide gas, you
should consider monitored carbon monoxide detectors.
23. Please provide the
following information about the residence you want to
protect.
Name:
Address:
City:
ST:
Zipcode:
Phone:
Email address:
Best time to call:
Comments:
24. When purchasing goods
or services, how do you prefer to pay for them?
Credit Card
Check
Cash
Automatic Bank Deduction
