Commercial Service Request Form
Contact Information
*
Prefix
First Name
Last Name
Company Name
*
Phone Number
*
-
Area Code
Phone Number
E-mail
*
example@example.com
Type of Cleaning Services
Property Type
*
Please Select
Church / Place of Worship
Commercial Building
Small Office
Medical
Dental
Other (Please Specify)
Frequency
*
One Time
Weekly
Bi-Weekly
Monthly
Quarterly
Other
Cleaning Options
*
Deep Clean
General Clean
Window Washing
Fridge Cleaning
Supply Restocking (toilet paper, paper towels, hand soap, etc)
Dishwasher/washing dishes
Empty trash bins and Recycling
Number of Bathrooms
*
Please Select
1
2
3
4
5
Number of office rooms
*
Please Select
0
1
2
3
4
5
6
7
8
Number of cubicles
*
Please Select
0
1
2
3
4
5
6
7
8
Number of kitchens / Break rooms
*
Please Select
0
1
2
3
4
Any additional information:
Subject Property
*
Street Address
Street Address Line 2
City
Province
Postal
Signature
*
Submit
Should be Empty: