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Cleaning Service Template 2 -Form Fill
Q1
First Name
Name
Q2
Last Name
Name
Q3
Email
Q4
Phone Number
Q5
How did you hear about us?
Referral
Web Search
Social Media
Q6
Street Address
Property Address
Q7
Street Address Line 2
Property Address
Q8
City
Property Address
Q9
State / Province
Property Address
Q10
Postal / Zip Code
Property Address
Q11
Total Square Footage
Q12
Type of Residence
Apartment
Commercial
Residential
Duplex/Triplex
Condo
Office
Other
Q13
Type(s) of Flooring
Tile
Carpet
Hardwood
Vinyl
Marble
Other
Q14
#of Bedrooms
1
2
3
4
5
6
7
8
9
10
Q15
#of Bathrooms
1
2
3
4
5
6
7
8
9
10
Q16
Services Requested ($40/hour)
Floors
Windows
Walls
Furniture
Garage
Carpets
Q17
Payment Method
Cash
Check
Credit Card
Purchase Order
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