Keepsake Request Form

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Your Name*

Preferred Contact Method*

Phone Number*

Format: (000) 000-0000.

Email*

Follow-Up Preference

Would you like to receive SMS text messages about your service request?

I consent to receive SMS from Keepsake PCO. Reply STOP to opt-out; Reply HELP; Message and data rates apply; Messaging frequency may vary.No

Which of our services interest you?*

Packing / UnpackingOrganizingCleaningKitchen Pack + Clean

Any pets we should be aware of for the sake of any of our staff with allergies?*

Are you looking to set up recurring cleaning services or a single cleaning service?*

SubscriptionSingle Service

Is your schedule flexible or do you need help on a specific day?*

FlexibleSpecific

Preferred Service Date*

Date

Preferred Cleaning Date

Date

2nd Pack Date Preference

Date

2nd Cleaning Date Preference

Date

What day of the week would you prefer for your recurring cleaning service?*

What frequency of recurring cleaning services are you interested in?*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

# of Bedrooms*

# of Bathrooms*

Total Square Footage of Residence

Leave blank, if you're not sure.

Please select from the menu below for any additional services you would like to add.

Interior Oven CleaningInterior Dishwasher CleaningRefrigerator/Freezer Interior CleaningInterior Cabinet Cleaning (Bathrooms/Kitchen/Built-Ins)Interior Drawer Cleaning (Bathrooms/Kitchen/Built-Ins)Interior, Reachable Window Cleaning

# of Cabinets*

Please enter the number of individual cabinets that you would like the interiors of cleaned. Each cabinet should be counted by individual door face. Please consider bathrooms, kitchen and any built in's around the residence.

# of Windows*

Please enter the number of window and sliding glass door panes that you would like cleaned. We only come with a small step-stool and are therefore not able to offer elevated windows or exterior services at this time. Our intent is to offer cleaning to those easily reached, hand smudged windows with this offering.

# of Drawers*

Please enter the number of individual drawers that you would like the interiors cleaned. This helps us manage our schedule and determine cost.

If you have any specific cleaning tasks or priority areas, please list them below.

Tell us more about your organizing needs. Is this a sort-and-toss, or a declutter, or something else?

Share any scheduling preferences such as day of the week or time of the day that works best for you.

Request Status*

1st Attempt

Client

Member Brand*