REQUEST A HOUSEKEEPER

BRUSSELS AND SURROUNDING AREA

Please complete the form below.

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À propos de vous

Last name

First name

Address

Postal code

City / Town

Email address

Phone number

Preferred contact method(s):

Email address

Phone

Best time to call you

Desired number of hours

Frequency of services

Please briefly describe the tasks to be carried out

Are you already registered with the service voucher scheme?

Yes

Are you using electronic or paper service vouchers?

What is your Pluxee user number?

Are there any pets present during the service?

Yes

If yes, please specify:

Do you have any comments or questions?