*Required fields in red
*Each checklist must have at least one box checked.* |
Business Name:
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Contact Name:
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Address:
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City:
State:
Zip:
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Phone Number:
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Best Time to Call During Day: (Please select AM or PM)
AM
PM |
E-mail Address:
Your e-mail address will not be given to anyone else and will only be used to communicate with you about our cleaning services. |
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Service Frequency: (Please check one)
5x per week
2x per week
Weekly
Bi-Weekly
Other - please explain:
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Total Square Footage to be cleaned:
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Floor Type: (Please enter the % of each type of floor)
% Carpet % Ceramic Tile
% Composite Tile
% Other - please explain:
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| # of Employees
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| # of Baths # of Commodes per bath
# of Sinks per bath |
To supply bath paper products: (Please check one)
Company MTP
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How did you hear about Maid to
Perfection®?:
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Comments/Special Requests:
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