request a household help

Service cheque: request for household help
1. Personal information
first name *
last name *
street *
number *
box
zipcode *
city *
2. Contact information *
e-mail
telephone
mobile phone
3. I am looking for household help
number of hours *

every week

every two weeks

prefered day

no preference

preference

tasks

cleaning

laundry and ironing

grocery shopping

cooking

stitching and sewing

Is your house reacheable via public transport?

no

yes

do you have pets?

no

yes

4. Administrative information We can personally fill out this information with you When you fill out more here, there is less paperwork later on.
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