Cunningham Cleaning Company, LLC.
New Customer/Service Request Form
Client Information
Please fill-out all required fields
First Name
*
Last Name
*
Your E-mail Address
*
Phone Number
*
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Area Code
Phone Number
Type a question
How did you find us?
*
Please Select
Google
Yahoo!
Yelp
Facebook
Pinterest
Twitter
HomeAdvisor
Angie's List
Living Social
My Guy Referrals
Referral
That's awesome! Please tell us who referred you
Date to Begin or Schedule a Service
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Month
-
Day
Year
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About The Home
Current Condition of Home (you may choose more than one)
*
The dogs/animals have taken over.
Clearly the kids don't care.
I just need a little help.
It's cleaned regularly, but can always use a deep clean.
Seriously, please help.
Girl, it's bad.
Don't judge me.
We just moved in
We're moving out
House is empty
Other
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Total Square Footage
*
Home, not lot size
Type of Residence
*
Single Family Residence
Apartment
Townhome / Condo
Other
# of Story Home
*
One Story
Two Story
Three Story
Other
Ownership
*
Own
Rent
Realtor
Property Management
Other
Type of Flooring(may choose more than 1)
*
Tile
Carpet
Hardwood
Vinyl
Other
Comments; questions or concerns:
Example: “The upstairs only has carpet in the bedrooms.”
CHOOSE YOUR SERVICE
# of Bedrooms
*
Please Select
One Bedroom
Two Bedroom
Three Bedroom
Four Bedroom
Five Bedroom
Six Bedroom
# of Bathrooms
*
Please Select
1 Bathroom
2 Bathrooms
3 Bathrooms
4 Bathrooms
5 Bathrooms
6 Bathrooms
7 Bathrooms
8 Bathrooms
Services Needed
*
One-Time Standard Cleaning
One-Time Detail Deep Cleaning
Weekly Service
Biweekly Service
Monthly Service
Move In/Out (Empty Home) Cleaning
Other
Any Additional Services
*
Wet-Wipe/Spot Clean Baseboards
Oven Cleaning
Sweep Garage
Above Cabinet Cleaning
Wipe/Clean Blinds
Wet-Wipe Ceiling Fans
Interior Windows/Glass washed and/or cleaned
Organization Services*
Other
Do you own any animals/reptiles or any other living thing in the home?
*
Yes
No
They're outside animals
Other
Preferred means of contact?
*
Cell
Email
Special Instructions
Restrictions
When would you like to begin or schedule a service?
*
This Week
Next Week
Future Date
Today (rush fee applies if applicable)
Other
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Month
-
Day
Year
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Terms and Conditions
*
Signature
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