| Name |
|
Email |
|
| Address |
|
City |
|
| State |
|
Zip |
|
| Day Phone |
|
Work Phone |
|
| Time Table For Cleaning |
|
Carpet Cleaning |
|
|
Please enter the approximate square footage of each room
|
| Family Room Sq.Ft. |
|
Living Room Sq.Ft. |
|
| Dining Room Sq.Ft. |
|
Master Bedroom Sq.Ft. |
|
| Bedroom 1Sq.Ft. |
|
Bedroom 2Sq.Ft. |
|
| Bedroom 3Sq.Ft. |
|
Bedroom 4Sq.Ft. |
|
| Bedroom 5Sq.Ft. |
|
Hall Sq. Ft |
|
| Stairs (Number of steps) |
|
Room 1 |
|
| Room 2 |
|
Room 3 |
|
| Room 4 |
|
Stain Removal Please give |
|
| Stain |
|
|
|
|
Furniture Cleaning
|
| Please provide details of furniture to be cleaned. 1. What color? |
|
Please tell us how you heard of our company |
|
| For other please explain here |
|
|
|
| Actual charges will be based on our final measurments once in your home |
| |
|
