Showplace Cleaning Service

Contact Information

*First Name	*Last Name

*Address of Location

*City

*Zip Code

*Contact Phone

*Preferred Contact Time

*E-mail Address

1. When would you like this service provided?

2. Check one of the following that apply to your request:

	This will be a recurring service
	This request is for a commercial location ( non-resident al work)
	This will be a one time service

3. What type of cleaning is needed?

	General Cleaning		Move-out
	Heavy Cleaning		Completion of Construction Project
	Window Washing		Hardwood Floor Care

4. Enter the square footage of house that needs cleaning?
Note: small house = approx.12,00, medium = approx.25,00, large = approx.35,00

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

Bedrooms

Bathrooms

6. How often does your home need cleaning?

7. What type of residence needs cleaning?

8. Do you have pets?

Yes

How many