Sparkles N Shine Cleaning: Cleaning Request Form

1
Full Name* This field is required.
First Name
Last Name
2
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
3
Phone Number* This field is required.
Area Code
Phone Number
4
Email* This field is required.
example@example.com
5
How did you hear about us?* This field is required.
6
Is this your first time booking with Sparkles-N-Shine Cleaning?* This field is required.
YESNO
7
What type of cleaning service are you booking today?* This field is required.
Residential Regular Cleaning
Residential Deep Cleaning
Move-In/Move-Out
Post-Construction
Airbnb
Commercial
Other
8
How frequently would you like us to clean your property?* This field is required.
One-Time
Weekly
Bi-Weekly
Monthly
9
Do you or anyone in your household have allergies or sensitivities to specific cleaning products (bleach, ammonia, fragrances, eco-friendly solutions)?* This field is required.
YESNO
10
If yes, please specify which products or ingredients to avoid* This field is required.
11
Are there any hazardous materials, mold, or pest infestations we should know about? * This field is required.
YESNO
12
Do you have pets? * This field is required.
YESNO
13
Do you have any children? (This helps us gauge typical wear and tear.)* This field is required.
YESNO
14
Type of Property* This field is required.
Single-Family Home
Apartment/Condo
Townhome
Commercial
Other
15
Are you the owner of the property?* This field is required.
YESNO
16
Square footage of property* This field is required.
17
Are you looking to have the whole property cleaned, or just certain rooms or areas? Please share the details.* This field is required.
18
Number of Levels/Floors* This field is required.
Please Select
Please Select
1
2
3
4
5+
19
Number of Living/Family Room * This field is required.
Please Select
Please Select
1
2
3
4
5+
20
Number of Bedrooms* This field is required.
Please Select
Please Select
1
2
3
4
5
6
7
8+
21
Number of Bathrooms* This field is required.
Please Select
Please Select
1
2
3
4
5+
22
How many are full bathrooms? How many are half bathrooms? Please share the details.* This field is required.
23
Kitchen Size* This field is required.
Please Select
Please Select
Small– Compact kitchen, fits 1–3 people, limited counter space.
Medium- Standard kitchen, fits 3–5 people, regular counter and cabinet space.
Large- Spacious kitchen, may include an island or breakfast area, lots of cabinets.
24
Type of Flooring* This field is required.
Please Select
Please Select
Carpet
Tile
Wood
Other
25
Number of Stairs* This field is required.
Please Select
Please Select
1
2
3
4
5+
26
Is the property furnished? * This field is required.
YESNO
27
Are there areas with heavy buildup (grease, grime, dust)?* This field is required.
YESNO
28
Are there any areas that require special attention? * This field is required.
YESNO
29
What areas should we avoid?* This field is required.
30
Choose Additional Services* This field is required.
Wet-Wipe Baseboards
Wipe/Clean Blinds
Wet-Wipe Ceiling Fans
Bed Making & Linen Change
Upholstered Furniture Vacuuming
Oven Cleaning
Fridge Cleaning
Garage Sweep & Dust
Steam Clean Bathrooms
Steam Clean Window Sills
Steam Clean Baseboards
Clean Finished Basement
Clean Unfinished Basement
Clean Sun-Room
Steam Clean Interior Closet Doors
Steam Clean Door Frames
Furniture Premium Treatment
Patio Glass Door Cleaning
Wall Spot Cleaning
Trash Bin Cleaning
Carpet Shampoo or Spot Treatment
None
31
How would you rate the cleanliness of your property on a scale of 1 to 10? (with 1 being very clean and 10 being very dirty)* This field is required.
Please Select
Please Select
1
2
3
4
5
6
7
8
9
10
32
When would you like to begin your cleaning service?* This field is required.
Date
Year
Month
Day
33
Upload pictures or a video of the condition of your property
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
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