Welcome to Mooresville, NC

Disclaimer: Information submitted on this form will be sent via email. To protect sensitive information, do not request the following information on this form: Social Security numbers, driver’s license numbers, bank account information, routing numbers, medical information, passport numbers, and passwords.

The Special Needs Registry is a free safety tool maintained by the Mooresville Police Department. This program allows Mooresville Residents with disabilities or special needs and their families, friends or caregivers an opportunity to provide information to the Police so that we can better plan to serve them in the event of an emergency. It can be vitally important to know that a resident at an address where help is needed, may have a visual, hearing or mobility condition; or any other special needs that officers need to be aware of.

Personal Information

Date of Application*

New Application/Update*

Name*

Address*

Date of Birth*

Gender*

Primary Phone*

For the Deaf & Hard of Hearing - Do you use sign Language: Yes or No - CapTel/VP/TTY #*

CapTel/VP/TTY#

If you answered yes above, use this area to explain.

Living Situation*

Other Living Situation

Medical Information (Check those that apply to your medical condition)*

Specify Condition or describe

Do you have pets in the residence that would hinder the Police if assistance is needed in the residence? If so, what types of pets are in the home? How many?

Do you have an alarm system?*

Name of Alarm Company and Phone Number

Do you keep a key hidden outside your home?*

If so, where is the key hidden?

Personal Information

Emergency Contact Information