Account Application Form for Emergency Callout service.
Your Current Address :
*
*
*
*
*
Your French Address :
( To which this Emergency relates)
*
*
*
*
Your Keys Location Address :
( This must be within Burgundy & you must ensure we can collect your keys at the required time)
*
*
*
*
Please specify the nature of the problem, how long since it occured and what are the biggest concerns you have; eg; damage, loss, theft, injury to others.
All replies will be sent to the following E Mail address:
* or, alternatively:
To the following Fax Number
By ticking this box I herby agree to allow representitives of A Piece of Burgundy to collect the keys to my french house, to enter the house and ascertain the extent and solutions to the problems outlined above and to arrange for these problems to be
remedied by the best means available. I agree that all third party bills (from contractors, artisans or other notified bills) will be paid by me, the undersigned. I agree to send payment for the services of A Piece of burgundy (@ £125 / 181 Euros) by electronic transfer or cheque as outlined in our
General Terms & Conditions.
We advise you to fill this form in completely, then e-mail it to 'assistance@apieceofburgundy.com' or print it, sign in the box below and phone our French office on 00 33 (0)3 80 93 77 25 to arrange for it to be faxed quickly. If you cannot reach us by phone we are out of the office and we recommend that you e-mail the form to us.
