Tell us a little bit about your cleaning needs... Please enable JavaScript in your browser to complete this form.Referrers DetailsWe need a little information about the referrer so that we are able to say who has contacted us on behalf of the Participant. If there is no referrer and you are contacting us for yourself, you do not need to complete this section.Referrers NameReferring CompanyReferrers Phone NumberParticipant DetailsThis section is required information that we will need to make a booking. Please complete all of the questions.Participants First Name *Participants Last Name *Participant address? *Address Line 1CityState / Province / RegionParticipants Phone Number *Participant email? *NDIS Reference NumberWhat email should we send invoices to? *What date would you like the services to start from? *What services would you like? *Recurring cleaningSpring cleanOrganisingOven cleanExit cleaningLawn mowing / Yard maintenanceWhat days of the week are you interested in? *MondayTuesdayWednesdayThursdayFridayPlease choose days that the participant is interested in and we will do our best to accommodate the request. Please note that we do not operate on Saturday or Sunday.Please estimate what time of day you would prefer your service to be *Mid morning (9am - 12pm)Mid afternoon (12pm - 3pm)How often would you like the cleaning? *One timeWeeklyFortnightlyHow many hours would you like to book? Selected Value: 0 Tell us more specifics about the household...The more information we have, the easier it will be to match you to a suitable cleaner.Do you have pets? *Cat/sDog/sReptile/sOtherNo petsWe use this information to make sure our cleaner does not have an allergy to your pets.How many bedrooms does your house have? *12345More than 6How many Bathrooms do you need to be cleaned?1234 or MoreHow did you find us? *Facebook postGoogle or another search engineWebsite directWord of mouthTik Tok postNameSubmit
