Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Security Check Form

  1. Reason for Patrol*

  2. Type of Premises:*

  3. Protected by alarm system:*

  4. Lights on:*

  5. Constant:*

  6. Automatic:*

  7. Keys left with anyone:*

  8. Please provide the following information of anyone with keys to your premises.

  9. In case of emergency, do you wish to be contacted?*

  10. Premises must be vacant for five or more days to be eligible for this program.

  11. I agree that I am allowing the Waukee Police Department permission to check my premises during the time period listed above.*

        1. Leave This Blank:

        2. This field is not part of the form submission.