To provide the best estimate possible,
please complete the following data:
* = Required Information

* Name
* Street Address
* City
* State
* Zip
* Preferred contact phone number and area code
* Email Address
Description of Home:
* What kind of home do you wish to have cleaned?	Private home Townhouse Condo Apartment Other
* What is the approx. square footage of your home?	1000 - 1500 1500 - 2000 2000 - 2500 2500 - 3000 3000 - 4000 4000 - 5000 5000 - 7000 7000 - 10,000 10,000+
* How many people live in your home?	1 2 3 4 5 6 7 8 9 10
* How many bedrooms?	1 2 3 4 5 6 7 8 9 10
* How many bathrooms? (Full and Powder)	1 2 3 4 5 6 7 8 9 10
* What additional rooms do you wish cleaned? Living room Dining room Family room Kitchen Den Office/study Sitting room Laundry room Mud room Library Great room Foyer Sun porch Game room Basement Conservatory Second or third staircase
* If you have any indoor pets, how many?	0 1 2 3 4 5 6 7 8 9 10
* Is there anything else we should know about your home?
Should we mail, e-mail or fax you our policy sheet for your review?	Mail      E-mail       Fax
Should we mail, e-mail or fax you our carpet cleaning information?	Mail      E-mail       Fax
	Fax Number
How often do you wish to have service?	Weekly Every other week Every four weeks Occasional One time clean
If one time, please specify:	Please Select One Move in or move out clean Carpet cleaning Construction clean up
How did you hear about The Maids Cleaning Service?	Please Select One You have seen our cars You are familiar with our office building on Maple Avenue We clean someone on your street or neighborhood Referral by friends or family Referral by realtor Referral by one of our business associates Valpak Radio - The Breeze Radio - The Point Internet Yellow Pages - Verizon Yellow Book Currents magazine Jersey Shore Coupon Guide Home Improvement Guide Caldwell Banker Concierge Program You received a brochure / flyer in mail You received a postcard TV commercial 1-800-the-maid
What prompted you to contact us today?

     

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The Maids Home Services
Phone:  (732)224-1105 Red Bank
Phone:  (732)333-2990 Freehold
Email: pkocenthemaids@aol.com
157 Maple Avenue • Red Bank, NJ 07701
11 Marcy Street #3 • Freehold, NJ 07728

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