Name *

First Name

Last Name

Phone *

(###)

###

####

Address of Property for Cleaning Service *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Property Type *

Residential / Home

Commercial / Business

How often would you like service?

Monthly

Quarterly

Semi-Annual

Annual / One Time

Weekly / Commercial

Home Many Stories High Is Your Property?

1

2

3

When will you be needing service?

ASAP

Within 1 Week

Within 2 Weeks

This Month

Estimated Number of Window Panes to Wash

Please count the panes of glass, not just the window frames. See bottom of page for example.

Under 10

10 - 25

25-35

35+

Would you like your gutters cleaned?

This is a popular add on service we provide to our window cleaning clients.

Yes

No

Maybe

Would you like your blinds cleaned?

Yes

No

Maybe