Cleaning Service Request
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
How did you hear about us?
Referral
Web Search
Social Media
Other
Total Square Footage
Area of Residence
Jackson
Teton Village
Airport
Wilson
Kelly
Hoback
Other
Type of Residence
Please Select
Apartment
Commercial
Residential
Duplex/Triplex
Condo
Office
Other
Type(s) of Flooring (select all)
Tile
Carpet
Hardwood
Vinyl
Marble
Other
#of Bedrooms
Please Select
1-2
3-5
5 or more
Not applicable
#of common areas (living rooms, break rooms, kitchen)
Please Select
<2
3-5
5-7
8 or more
Not applicable
#of Bathrooms
Please Select
1
2
3
4
5
6
7
8
9
10
Type of cleaning
One-time
Consistent
Are you interested in learning about our cleaning memberships?
I’d love to hear about the memberships now
I’d love to hear about the memberships NEXT time
Any special requests?
Below sections will be filled out by the Company.
Quote
Price ($)
Hours per week
Total Cost ($)
Floors
Windows
Walls
Furniture
Garage
Carpets
Total Amount ($)
Quote Prepared by
First Name
Last Name
Signature
Submit
Submit
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