| * | Name | |
| * | Please be advised that your information will not be sold. It will only be used if you allow us to contact you or service your home. | |
| * | Street Address | |
| * | City | |
| * | State | |
| * | Zip | |
| * | Preferred contact phone number and area code | |
| * | Email Address | |
| * | What kind of home do you wish to have cleaned? | |
| * | What is the approx. square footage of your home? | |
| * | How many people live in your home? | |
| | | |
| * | How many bedrooms? | |
| * | How many bathrooms? | |
| * | How many other rooms do you wish cleaned? Please include kitchen, dining area,
breakfast area, entry areas, laundry rooms, living areas, recreation
areas, library, fitness room, all other areas you wished cleaned.
Please exclude hallways, stairs & bedrooms. | |
| * | If you have any indoor pets, how many? | |
| * | Our regular price includes vacuuming of all floors and hands-and-knees
washing of your kitchen, bathrooms and entry areas. Do you need more
than this on the rest of your floors, such as wood treatment? | No Yes |
| | How often do you wish to have service? | |
| | If one time, please specify: | |
| | How did you hear about The Maids Home Services? | |
| | What is your number one reason for looking for a maid service? | |
TM 
