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Our agencies
Madou
Anderlecht
Leuven
Antwerpen
Jette
Waregem
Roeselare
+32 2 223 58 48
Step
1
of
13
7%
What kind of services are you interested in?
(Required)
cleaning
ironing
window cleaning
preparing simple meals
grocery shopping
Your home type:
(Required)
home
apartment
What is the surface area of your house/apartment? (in square meters)
(Required)
50-90
90-150
150-300
300 or more
How often do you need service?
(Required)
every day
once a week
once every 2 weeks
Other
How many hours of service do you need per day?
(Required)
3
4
5
6
7
8
9
During what hours do you prefer to get service? Select min. 2 preferences
Monday
before noon
afternoon
Tuesday
before noon
afternoon
Wednesday
before noon
afternoon
Thursday
before noon
afternoon
Friday
before noon
afternoon
Saturday
before noon
afternoon
Do you have any pets?
(Required)
dog
cat
I do not have any pets
other
pets-other-form
(Required)
spider
guinea pig
ferret
hamster
rabbit
birds
fish
rat
snake
mouse
turtle
other
Pluxee number
(Required)
Which type of service vouchers do you currently use, paper or electronic?
(Required)
Paper
Electronic
Preferred date of first service (min. in 5 days)
(Required)
DD slash MM slash YYYY
In which languages can we communicate with you?
(Required)
FR
NL
EN
PL
Other
lang_other
(Required)
DE
IT
ES
PT
AR
GR
TR
RU
RO
BG
Your email
(Required)
Enter Email
Confirm Email
GSM
(Required)
How do you want us to contact with you?
(Required)
e-mail
sms
phone call
Full Name
(Required)
Salutation
Mr.
Mrs.
Prefix
First
Last
Adress
(Required)
Ulica
Miasto
Kod pocztowy
Employee name
(Required)
Employee surname
(Required)
Agency
(Required)
Madou
Anderlecht
Leuven
Antwerpen
Jette
Waregem
Roeselare
What else can we do for you?
Acceptance of the conditions general
(Required)
I declare that I have read the
conditions general
and accept its provisions.
Acceptance of the data processing
(Required)
I declare that I have read the
data processing
and accept its provisions.
