| Name |
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| E-mail |
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| Address: |
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| City: |
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| State |
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| Zip |
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| Day Phone |
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| Work Phone |
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| Time Table For Cleaning |
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1 to 2 weeks 3 to 4 weeks
5 weeks or more |
| Carpet Cleaning |
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Regular Steam Fast Dry
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| Please enter the approximate square footage
of each room |
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| Family Room Sq.Ft.: |
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| Living Room Sq.Ft. |
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| Dining Room Sq.Ft.: |
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| Master Bedroom Sq.Ft.:: |
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| Bedroom 1Sq.Ft.: |
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| Bedroom 2 Sq.Ft.: |
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| Bedroom 3 Sq.Ft.: |
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| Bedroom 4 Sq.Ft.: |
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| Bedroom 5 Sq.Ft.: |
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| Hall Sq. Ft. |
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| Stairs (Number of steps) |
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| Room 1: |
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| Room 2: |
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| Room 3: |
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| Stain Removal Please give: |
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| Stain |
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| Furniture Cleaning |
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| Please provide details of furniture to be
cleaned. 1. What color? |
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| Please tell us how you heard Beckett's |
|
Mamma Google Lycos Other |
| For other please explain here: |
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| Actual charges will be based on our final
measurements once in your home, therefore the only
reason why any pricing will change will because
you wanted something else done or the final
measurements were different then what was sent to
us!. |
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