Alarmquip Security Systems – QLD DOE Register New Lift

School Name*

School Location Code / Centre Code*

School Region*

Main School Phone Number*

Address*

Street Address Address Line 2 City State Post Code

Lift Location*

Lift Manufacturer*

Does this lift have a single SIM or dual SIM device?*

Brand of Cellular Device?*

Model of Cellular Gateway Device?*

Programming Passcode

If the device has a passcode to remotely change setting, enter it here.

Location of Cellular Gateway Device*

Telstra Service Number*

Telstra PUK Number*

Telstra SIM Number*

Unique SIM card number located on the SIM.

Optus Service Number*

Optus PUK Number*

Optus SIM Number*

Unique SIM card number located on the SIM.

During School Hours Keyholders*

Keyholder Position	Keyholder Phone

During School Hours Other Response

Do You Require a Different Set of Keyholders for After Hours?*

After School Hours Keyholders*

Keyholder Position	Keyholder Phone

After School Hours Other Response*

Your Name*

First Last

Your Company*

Your Position*

Confirmation*

I confirm I'm authorised to supply this data and I understand this data must be true and correct and will be used in an emergency situation where the safety of others is concerned.