General Information
First Name:
Last Name:
Street Address:
City:
State:
DC
MD
VA
Zip:
Email Address:
Home Phone:
Cell Phone:
How did you hear about Budget-Maids:
Internet Search Engine
Postcard
Office Sign
Car Sign
Referral
Employer
Angie’s List
Previous Customer
Estimate Criteria
Preferred Start Date:
Preferred Arrival Time:
Morning
Afternoon
How many persons living in the home:
Type of service:
Housekeeping
Dry Clean Carpet
Housekeeping & Dry Clean Carpet
Frequency:
(Select all you want to receive a quote for)
Weekly
Bi-Weekly
Tri-Weekly
Monthly
One Time Only
Type Home:
Condo
Apartment
Townhome
Single Family Home
Estimated square footage:
700-1,500
1,600-2,000
2,100-2,500
2,600-3,000
3,100-3,500
3,600-4,000
4,100 +
Additional Services:
(Optional additional services costing $30 each - Applies to One Time/First Time Only)
Inside oven
Inside refrigerator
Inside cabinets
Room Count for Housekeeping:
Bedrooms:
Full bathrooms:
Half-bathrooms:
Kitchen:
Living Room:
Office/Den:
Entry Way/Foyer:
Dining Room:
Family Room:
Basement:
Pets:
Room Count for Carpet Cleaning:
Bedrooms:
Hallways:
Staircases:
Living Room:
Dining Room:
Office/Den:
Entry Way/Foyer:
Family Room:
Basement:
Pets:
Other:
Special Instructions:
I agree to the
terms and conditions
