• Cleaning Service Application Form

• 
  
• Date
• Name*
• Phone

  --
• Email
• Address

  Street Address 1

  Street Address 2

  City

  State/Province/Region

  Postal/Zip Code

  Country
• What is your availability?* Select Morning Afternoon Evening Weekend No Preference
• How many years of residential cleaning experience do you have?*
• What size home do you typically clean? (Check all that apply.)*

  800-1200 sq. ft. 1200-1900 sq. ft. 1900-2500 sq. ft. 2500-3100 sq. ft. 3100 sq. ft. or more
• Are you insured for residential cleaning?*

  Yes No
• Do you have reliable transportation?*

  Yes No
• Do you have your own cleaning supplies?*

  Yes No
• Do you work with a cleaning partner(s)?*
  Yes. No, I work alone.

  If yes, how many per visit?
• 
  
• Please provide cleaning references for the past three years.

  Name	Phone#	Home Address

• 
  
• Signature