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eRegister for the Block Watch Program

Using the following electronic form, Register YOUR Charlestown, Indiana Residence for participation in the Block Watch Program.

 

The Block Program has three main objectives;

● The Prevention of Crime

● Emergency Preparedness

● Building Closely Knitted Neighborhoods

 

eRegistration Form for Charlestown Block Watch participation:

 

Directions:  Complete the following form a click "submit" to send your registration for participation.  Information is required in certain boxes, as indicated by " * " to the left.

 

 

* Yes, I / We would like our Charlestown Residence to be involved in the Block Watch program.

 

* Residence Contact Name(s):

 

* Residence Address:

 

   Contact Telephone Number(s):

 

* E-Mail Address(es):

(Email addresses will be held confidential and used solely for Block Watch purposes)

 Directions:  Click on the circle to select the following options:

 

  I / We would like to attend Block Watch Program Meetings.

 

  I / We would be interested in serving on a Block Watch Program committee.

 

Click SUBMIT ONCE to send your eRegistration.                                Click RESET to clear the above information. 

 

                                                                                            

** For more information about the Charlestown Block Watch Program, Click HERE.

 

[ Return to the Charlestown Block Watch Home Page ]
 

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