INFORMATION REQUEST FORM

What type of cleaning is needed? General cleaning (potentially recurring) Heavy Cleaning (one-time event) Other

Move-out Completion of construction project

Enter the square footage for the house that needs cleaning. Note: small house = approx. 1,200, medium = approx. 2,500, large = approx. 3,500

How many bedrooms and bathrooms are in the home to be cleaned?

Bedrooms

Bathrooms

	What specific types of cleaning services are desired? (Check all that apply)

Window washing Ironing Wipe down walls Wipe blinds Carpet Shampoo Clean bathroom surfaces Damp mop floors Change bedding Other

Laundry Dishes Wipe down woodwork Organizing Vacuuming and dusting Clean Kitchen surfaces Strip/wax floors Oven/stove cleaning

For general cleaning (recurring service), how often does your home need to be cleaned?

Daily Bi-weekly Bi-monthly Annually Other

Weekly Monthly Semi-annually Seasonally

	Who will provide the cleaning supplies?

Cleaning service Both

Homeowner

What type of residence needs cleaning

Home Condominium Duplex

Apartment Townhome Other

	Do you have pets?

Yes

No

	Provide a detailed description:

	CONTACT INFORMATION

* First Name

* Last Name

	* Address (Location of Request)

* City * Zip Code How may we contact you? * Daytime Phone EXT Preferred Contact Time Select One Any_Phone_Anytime Cell_Phone_Anytime Morning Mid_day Evening

* Email Address * Evening Phone    * Cellular Phone

 

Thanks for visiting and we look forward to serving you.

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