Business Registration
This online form is for business owners to provide their emergency contact information to the Kauai Police Department.
Thank you for your cooperation. If you have any questions, you may contact Dispatch Supervisor Kathleen Langtad at (808) 241-1722.
*
Indicates Required Information
Business Name and Emergency Contact
Business Name:
*
Business Address:
*
Number
Street Name (ex. Kuhio)
Avenue
Circle
Drive
Highway
Lane
Loop
Place
Road
Street
Way
Street Type
Suite # (optional)
City
Zip Code
Business Phone:
*
(1)
###-#### or ###-###-####
(2)
Owner Name(s):
Phone:
(H)
(C)
Alarm Company:
Phone:
Additional Information:
Emergency Contacts
Name:
*
Phone:
*
(H)
(C)
Name:
Phone:
(H)
(C)