Residential Cleaning Estimate
First Name *
Last Name *
City *
State *
Email Address *
Phone Number
Square Footage of Home *
Unknown	Unknown?
Frequency of Service *	Please select One Time Weekly Biweekly Monthly Deep/Spring Cleaning Move In/Out As Needed
Bathrooms *	Yes   No
If yes, how many in your home	Please select 1 1.5 2 2.5 3 3.5 4 4.5 5+
Kitchen *	Yes   No
If yes, what type of flooring	Please select Hardwood/Laminate Linoleum Tile/Concrete/Marble CarpetOther
Dining room *	Yes   No
If yes, what type of flooring	Please select Hardwood/Laminate Linoleum Tile/Concrete/Marble CarpetOther
Main Living room *	Yes   No
If yes, what type of flooring	Please select Hardwood/Laminate Linoleum Tile/Concrete/Marble CarpetOther
Bedrooms *	Yes   No
If yes, how many in your home	Please select 1 2 3 4+
How many are carpeted?	Please select01234+
Other flooring types (choose any that apply)	Tile/Concrete/Marble   Hardwood/Laminate   Linoleum   Other
Hearth room and/or additional living room *	Yes   No   Both
If yes, what type of flooring (choose any that apply)	Carpet   Tile/Concrete/Marble   Hardwood/Laminate   Linoleum   Other
Home office *	Yes   No
If yes, what type of flooring	Please select Hardwood/Laminate Linoleum Tile/Concrete/Marble Other
Bonus and/or Rec. room *	Yes   No   Both
If yes, what type of flooring (choose any that apply)	Carpet   Tile/Concrete/Marble   Hardwood/Laminate   Linoleum   Other
Laundry room *	Yes   No
Any rooms not previously mentioned	Yes   No
If yes, Please list
What type of flooring (choose any that apply)	Carpet   Tile/Concrete/Marble   Hardwood/Laminate   Linoleum   Other
Do you have inside pets? *	Select One Yes No
If yes, how many?	Please select 1 2 3 4 5+
Please list types of animals
Any Additional Information You'd like us to know
How did you hear about us? *	Please selectInternet Search Engine Phone Book Yellowpages.com Facebook Advertisement Referral Other
If you were referred by one of our customers, please list their name below. A Touch of Class offers Referral Discounts.