Partner Registration
Already a Registered Referral Partner? Click Here

To register to become a Referral Partner please complete the following form and click Submit.

*Required Field.

First Name


 Last Name
Address
City
State


 Zip Code
Primary Phone


 Cell Phone
E-mail Address*


 Preferred Method of Contact
E-Mail
Phone
Referrence Number
(if you have one)


 Partner Company Name
(if there is one)

Privacy Statement:
The information which you give in completing this form will not be provided by us to any other parties. If you wish information concerning the privacy policy or ADTS Inc.,please call 850-477-5054.

Do you own your home or rent?*

 

 
Do you own a security system?*

 

 
First Name:*
Last Name:*
Phone:*
Zip Code:*
Email:
Alt. Phone:

 

$99.00 Customer Installation Charge. 36-Month Monitoring Agreement required at $35.99 per month ($1,295.64). Form of payment must be by credit card or electronic charge to your checking or savings account. Offer applies to homeowners only. Local permit fees may be required. Satisfactory credit history required. Certain restrictions may apply. Offer valid for new ADT Authorized Dealer customers only and not on purchases from ADT Security Services, Inc. Other rate plans available. Cannot be combined with any other offer.