Cleaning Client Information Form

Cleaning Client Information Form
Customer Information
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone*
Format: (000) 000-0000.
Email*
Preferred Phone
TextEmail
About the home

Client's Home Information
Please check all preferred days for cleanings (including the day we have you scheduled for)*
Please check your preferred times of the day for cleanings*
# of bedrooms*
# of bathrooms*
Approx. square foot*
# of stories*
More than 50% carpeted
Oven CleaningFridge CleaningLaundry ServiceDishwashingCarpet CleaningWindow CleaningUpholstery CleaningOrganizingOther
Client will provide cleaning supplies.Cleaning company to provide cleaning supplies.
Special Instructions or Notes:
List tasks to exclude:
Signature

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