Thank you for your interest in Dial-A-Mop.  We will need some information to complete your estimate request. The more information you complete on the form below will enable us to be more accurate with your estimate. Once you have completed the form click on the "SEND" buttom.  We will do our best to respond the same business day.  Freedom from housecleaning is a few clicks away! 

How did you hear about us: Please Make A Selection Vehicle Signs Internet Google Internet Yahoo Internet Search SuperPages Yellow Pages Suburban Home & Garden Magazine Clipper Magazine ValPak Money Mailer Service Magic Merchant Circle Post Card Door Hanger Referral SuperTradeExchange Cleaning For A Reason Women Of Gloucester County

First Name: Last Name:

Address:

City:   State:   Zip Code:

Best time to contact me:  Choose Time Anytime Morning 8-11 Afternoon 1-4 Evening 6-8

How should we contact you: Please Contact Me By Daytime Telephone Evening Telephone Email

Email:

My daytime phone is: ( ) - -

My evening phone is: ( ) - -

Type of Residence & Service:
  This is my: Primary Residence  Rental Property

Number of Occupants?   Number of pets?  

Type of Residence: Select Type Single Family Condo Townhome Twin/Duplex Apartment

Square footage of Home: Please Select One Less than 1000 1001 - 1400 1401 - 1800 1801 - 2300 2301 - 2600 2601 - 3000 3001 - 3500 3501 - 3900 4800 & Up

Number of levels?     Number of staircases?

My space is best described: Please make a selection Lots of treasures love them all Minimalist - I like few things. Tidy & Organized Some rooms empty Need help picking up

Special Needs: None Allergies COPD Patient Other Please Make A Selection

Service Frequency: Select Frequency Top To Bottom Deluxe Weekly Cleanings Bi-weekly Cleanings Monthly Cleanings One Time Cleaning Move In Cleaning Move Out Cleaning Post Construction Cleaning Special Cleaning Green Cleaning New Construction Phase Cleaning Windows ONLY Carpets ONLY

When do you need service? Please Select One ASAP Within Days Next Week Next Two Weeks No Rush Planning & Budgeting

Kitchen:  
      Cabinetry: Please Select One None Wood Laminate Lacquer Painted Other
      Counters: Please Select One Granite Corian Silestone Quartz Zodiaq Stainless Steel Laminate Formica Ceramic Tile Concrete Wood - Butcher Block Other
      Island: Yes No    Pantry (walk-in):  
     Eat-in with table and chairs:   Breakfast/Morning Room:  
     Stainless Steel Appliances: Yes No   Range:  Cooktop/Wall Oven:  
     Sliding/Glass Exit Door:  

Living Space & other rooms:
    Foyer:        Living Room:       Dining Room:  
      Family Room:         Great Room:   Media Room
      Library/Study:       Office:
     Sunroom:     Loft:    
     Gym Bonus Rooms:   Laundry Room:  Mud Room:
     Basement: Please Select One None Finished Unfinished Partially Finished

Bedrooms:
       How many bedrooms? 0 1 2 3 4 5 6    
       Walk in closets ? Yes No     How many? 0 1 2 3 4 5
      Change linens? Please Select One None 1 Bed 2 Beds 3 Beds 4 Beds 5 Beds 6 Beds

Bathrooms:
       How many bathrooms? 0 1 1.5 2 2.5 3 3.5 4 4.5 5 6  
       Garden Tub/Jacuzzi:  
       Shower  Glass Shower Doors ? Yes No   How many pairs? 0 1 2 3 4 5
       How many standard Bathtubs   0 1 2 3 4 5 6
       How many sinks?  0 1 2 3 4 5 6   How many commodes?   0 1 2 3 4 5 6
       Change Towels? Yes No

Number of Ceiling Fans?

Window Dressings:
               Draperies?  Yes No   How many?  
               Window Shades? Yes No  How many?  
                       Types: Cellular Honeycomb Fabric
               Window Blinds?  Yes No   How many?  
                        Types: Vinyl Aluminum Wood   Verticals
               Window Shutters? Yes No   How many?  
                         Types: Plantation Shutters Stained Wood Shutters

Flooring:  (please check all that apply)
         Carpeting:
              Pile Shag Berber Area Rugs  Other
         Hard surface:
              Hardwood Laminate Pergo  Bamboo
              Tile Stone Marble Vinyl Porcelain
              Concrete Other

Will you need any extra add on services;  
      Refrigerator (inside hand washed):  Yes No
      Oven (inside):     Self Cleaning: Yes No

   Windows cleaned:  Yes No
     How many windows?
         Inside ONLY   Inside & Outside
              Types of windows: 
              Tilt-in (bottom only)  Tilt-in (top & bottom)
              Double-hung Bay/Bow Casement Palladian
              Gliders Picture Skylight     

    Carpets cleaned: Yes No

Have you ever had your home cleaned professionally?  Please Select One Yes No
  Please check all that apply;
      Service Individual  Other  This will be the first time

Please share with us your experience?
  Please Select One Terrible that's why I am contacting you Okay, not the best Very Good Excellent   

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