Southern Kiwi Cleaning Intake Form
Your Name
Mr.
Mrs.
Miss.
Prefix
First Name
Last Name
Email Address
example@example.com
Contact Number
Please enter a valid phone number.
Property Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please choose property type.
Apartment
Single family home
Short Term Rental (AirBnb)
Office
Event Space
Other
Please Indicate Total Sq Ft Of Property
*
Total Number of Bedrooms
Total Number of Bathrooms
What type of flooring is primarily used throughout the home? (e.g., hardwood, tile, carpet, vinyl, combination, etc.)
Are there any natural stone, travertine, brass, or other custom materials in your home that require special cleaning?
Any pets? (If so, type and number of pets)
Requested Cleaning Frequency
Please Select
Weekly
Biweekly
Monthly
One time
Package Requested
Please Select
Essential Shine
Deep Radiance
Fresh Start Detail
After Event Revival
The Turnover
Kiwi ProShine
Kiwi Prestiege
Requested Date & Time
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Preferred Contact Method
Please Select
Call
Email
Text
How did you hear about us?
Please Select
Facebook
TikTok
Google
Reference
Other
Signature
Please verify that you are human.
*
Continue
Continue
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