Cleaning Service Agreement Form

1
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
United States
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
Cell Phone
Area Code
Phone Number
4
Home Phone
Area Code
Phone Number
5
E-mail* This field is required.
6
How soon would you like to start your service?
7
How often would you like service?
Weekly
Every 2 Weeks
Every 4 Weeks
Just 1 time
8
Is this service a MOVEOUT Cleaning?
YESNO
9
Please Enter Your New Address You Will Be Moving to.
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
10
We have 3 locations, which of our branches are you the closest to?
Fargo
Grand forks
Detroit Lakes
11
Are you a year round client or a seasonal client?
Year Round
Seasonal
12
Times Allowed* This field is required.Please let us know what times work ok for you. The 1st option provides us with the most flexibility and we will love you even more for that !!!!
Arrival after 8am- Done by 5pm ( Our preferred flexible time frame)
Arrival anytime between 8a-12pm
Arrival after 12pm- Done by 5pm
Arrival after 8am- Done by 3pm
8- 9am arrival ( these openings are rare)
13
What days would work for your schedule? ( Click all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Anyday Monday - Friday
14
Form of Entrance on the day of service?
Garage Code
Door Left Unlocked
Key
I will be there to let cleaners in
Other
Electronic Door Code
15
You chose "other" for the form of entrance. Please explain* This field is required.
16
Please enter the garage code below
17
Please enter the door code below
18
Please tell us which door will be unlocked
19
Would you like us to lock up when we leave?
YESNO
20
Based on your estimate and your preferences, are there any rooms we will not be cleaning?* This field is required.
YESNO
21
Which rooms will be not be cleaned / not included in your estimate ?* This field is required.We will note- Do not clean Kids bathroom, office or master bedroom to the cleaners. Please describe the rooms so we know which one is which. This helps the communication to our cleaning techs.
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Normal
Small
Ok
Ok
22
How did you hear about TLC Cleaning? * This field is required.If it was by a referral please indicate the person's full name and number so we can thank them.
23
Do you have pets in the home?
YESNO
24
Please describe any pets including names and special instructions
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Small
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Ok
25
Feel free to take a photo and send us if you need to of anything in your home you are wanting to show us or inform your cleaners about.
26
SPECIAL INSTRUCTIONS for your home Please tell us any information your cleaners should know to be successful for you.
27
Tell us a little bit about why you are booking with us today to better provide a more personal experience for you Let us get to know you
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Ok
Ok
28
Would you like to make a 1-time purchase of any of our amazing cleaning products? We will bring these out to your cleaning or mail them out for you. ( Check all the apply, ND sales tax is added)* This field is required.
10 Pack of erasers- $8.00
20 Pack of erasers- $15.00
1- 28 oz Ready to use all natural multipurpose cleaner ( Simply Clean) $10.00
1 - 1 Gallon Concentrate of all natural multipurpose cleaner ( Simply Clean) $20.00
1- Simply Sample ( Small purse size ) all natural multipurpose cleaner ( Simply Clean) $3.00
12 pack of professional grade microfibers $24.00
24 pack of professional grade microfibers $40.00
No Thank You
29
Tell us about your pet peeves... If we did something or maybe didn't do something that drove you crazy what would it be?We want to make sure we take note of these pet peeves so we have a good relationship long term.😍
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Ok
30
Terms and Conditions* This field is required.
31
Signature* This field is required.1) I have read and agree to TLC Cleaning's Service Policies and Agreements indicated at www.tlccleaningexperts.com/welcome. 2) I understand I will be charged for the full amount of my cleaning on the day of service. 3) I understand TLC Cleaning requires a 48-hour notice in order to provide our staff with stable jobs. The full rate will be charged. Please type or sign your name below to agree to the above statements.
32
How did you hear about TLC Cleaning?
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