Registration

Thank you for choosing K & R Agency to meet your domestic placement needs. For further information on available staff and what we could be of assistance offering you, please fill out our client registration form below. Upon reviewing your needs and contact information we will respond within 1 business day to request more detailed information.

Registration/Membership Form

Name: *

Estate/Household of: *

Street Address: *

City/State/Zipcode *

Phone Number *

Alternate Phone Number: *

E-Mail Address: (Payment confirmation is sent to this e-mail) *

How did you hear about us? *

How soon would you like to hire a staff member? *

Specify Staff Position(s) (i.e. nanny) *

Are there currently staff members in your household? *

Yes No

Please in the best detail you can, tell us your staffing needs: *