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To sign up for K&K’s Concierge Lawyer Service For the Alarm Industry program please fill out the below application. Your participation starts as soon as your application is processed and you receive confirmation. Participation in this program is limited, so don’t delay.
Client Name: Middle Name Last Name
Client Cell Phone:
Client Home Phone:
Client Email Address:
Client Home Address:
Company Name:
Company Address: State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennslyvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Canada: Alberta Canada: British Columbia Canada: Manitoba Canada: New Brunswick Canada: Newfoundland Canada: Nova Scotia Canada: Ontario Canada: Prince Edward Island Canada: Quebec Canada: Saskatchewan Select a State / Provence Virgin Islands Puerto Rico FEDERAL (ALL STATES) Zip
Company Phone Number:
Company Website:
Company License:
Licensing Authority:
The undersigned applies for participation in the K&K’s Concierge Lawyer Service For the Alarm Industry program and agrees that the credit card listed below shall be charged as noted below:
$145 per month, such charges to be automatically charged to the below credit card each month until participation in the program is terminated.
$1595 to be charged now and every year until participation in the program is terminated.
Card Number:
Expiration Date: 01 - January 02 - February 03 - March 04 - April 05 - May 06 - June 07 - July 08 - August 09 - September 10 - October 11 - November 12 - December Expiration Date: 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034
CVV Code:
Zip code where card is billed:
The undersigned authorizes the above card to be charged as noted above:
Type name of card holder:
Important, you must agree to the following by checking the boxes (5) below or your order cannot be filled:
Participation in K&K’s Concierge Lawyer Service For the Alarm Industry K program requires a 6 month commitment and you may cancel anytime thereafter.
Client authorizes K&K to retain clients credit card information and charge the monthly or annual fee when due.
Client acknowledges that other professional services provided by K&K will be invoiced.
By joining our email list you will be kept up to date on contract changes, receive articles on legal and other industry topics. There is no charge for this service. Check box to opt in to receive our emails.
Jurisdictional Agreement: Client acknowledges and agrees that any claim or dispute against Kenneth Kirschenbaum and Kirschenbaum & Kirschenbaum PC must be commenced and maintained exclusively in Nassau County, New York, and that Kenneth Kirschenbaum and Kirschenbaum & Kirschenbaum PC shall not be subject to any other jurisdiction.
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