Elevate Home Concierge — Member Enrollment Form
Please complete this form to help us manage your property efficiently. All information will remain confidential.
Where is your property located?
*
Nassau County
Queens
Catskills / Sullivan County
Is this your primary residence or a vacation/second home?
*
Primary Residence
Vacation / Second Home
Contact Information
First Name
*
Last Name
*
Primary Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Preferred Contact Method
Please Select
Phone call
Text message
Email
WhatsApp
Best Time to Reach
Please Select
Morning 8am-12pm
Afternoon 12pm-5pm
Evening 5pm-8pm
Anytime
Additional Contact Name
Additional Contact Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Contact Email
example@example.com
Relationship
Please Select
Spouse/Partner
Co-owner
Family member
Other
Property Details
Primary Residence Address
Primary Residence Street Address
*
Primary Residence City
*
Primary Residence State
*
Primary Residence ZIP Code
*
Summer Home Property Details
Colony / Development Name
Summer Home Street Address
*
Unit Number
Summer Home City
*
HOA
Yes
No
Square Footage
Bedrooms
Bathrooms
Garage
Yes
No
Pool or Spa
Yes
No
Known Issues or Special Notes
Home Insurance Carrier
Access & Emergency
Entry Method
Please Select
Key
Keypad
Lockbox
Other
Colony Gate Code
Home Keypad Code
Alarm Code
Pets on Premises
Yes
No
Special Access Instructions
Emergency Contact 1 Name
*
Emergency Contact 1 Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact 1 Email
example@example.com
How did you hear about us?
Please Select
Referral
Google search
Social media
Nextdoor
Other
Who referred you?
Back
Next
Select Your Plan
Essential — $299/month
Essential Plus — $599/month ⭐ Most Popular
Premier — $999/month
Homewatch — $99/month
Catskills All-Inclusive Annual Program — $99/month (1-Year Commitment)
I understand and accept the Catskills All-Inclusive Annual Program at $99/month with a 1-year commitment.
*
I understand and accept
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Next
Elevate Home Concierge Services Agreement
Please review our full Services Agreement before completing your enrollment. By checking the box below, you agree to be bound by the terms of the Elevate Home Concierge Services Agreement.
Click
here
to view the Full Services Agreement (PDF)
I have read and agree to the Elevate Home Concierge Services Agreement and authorize Elevate Home Concierge to charge my payment method on a recurring monthly basis in accordance with my selected plan.
*
I agree
Full Name (type your full name to confirm agreement)
*
First Name
Last Name
Agreement Date
*
-
Month
-
Day
Year
Date
Your card will be charged the prorated amount for the current month today. Your full monthly subscription charge begins on the 1st of next month. All payments are processed securely through Stripe.
Payment
I authorize Elevate Home Concierge to charge my payment method provided for any additional invoices issued for services outside my subscription plan. I will be notified before any such charge is processed.
Complete My Enrollment
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