Servicing South and Central Taranaki
800-123-4567, Fax: 718-724-3312
officeone@youremail.com
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About You

Your First Name:
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Your Last Name
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Your Phone Number
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Your Date of Birth
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Your Address
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Your Email Address
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Your Mobile Number
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Emergency Contact Name
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Emergency Contact Phone Number
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Regular Cleaning Service Requested

  • - select a option -
  • Classic Service - Residential Cleaning
  • Delux Service - Residential Cleaning
  • Bundle of Joy - 6 Week Package
  • Down on the Farm Package
  • Spring Clean Service
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Additional Services

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Preferred booking start date (subject to service availability)
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How often would you like us to visit
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One-Off Cleaning Packages Requested

  • - select a option -
  • Classic Service - Residential Cleaning
  • Delux Service - Residential Cleaning
  • Bundle of Joy - 6 Week Package
  • Down on the Farm Package
  • Spring Clean Service
  • After Builders Clean
  • Laundry Service
  • Moving Home / End of Tenancy Package
  • Personal Organisation Services
  • Unpacking Service
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One-Off Additional Services

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Preferred booking date (subject to service availability)
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Preferred Time
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  • 8.00 AM
  • 9.00 AM
  • 10.00 AM
  • 11.00 AM
  • 12.00 PM
  • 1.00 PM
  • 2.00 PM
  • 3.00 PM
  • 4.00 PM
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List any priorities you may have that you wish to include in your service

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About Your Home

How many square meters is your home
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Does your kitchen have a scullery?
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  • Yes
  • No
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How many levels is your house
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Number of living areas
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Number of bedrooms
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Number of bathrooms
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Number of adults
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Number of children
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Number of indoor pets
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Dust Level
  • Light
  • Medium
  • Heavy
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Mildew Level
  • Light
  • Medium
  • Heavy
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Pet Hair Level
  • Light
  • Medium
  • Heavy
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Soap Scum Level
  • Light
  • Medium
  • Heavy
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How will we access your property?
  • I will be home
  • I will provide a key
  • I will provide an access code
  • Other
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Parking Instructions
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What's your favourite scent/fragrance?
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What are your childrens names?
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What are your pets and their names?
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Is there anything else we need to know?

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For a copy of our Customer Guidelines and Agreement for Residential Cleaning please CLICK HERE
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