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Service Ordering For Home Cleaning

Please fill in your information: New Customer   Existing Customer

Gender :   Miss   Mrs   Mr

First Name :
Last Name :
Contact Phone :
Email Address :
Fax :
Service Address :
Gross Size of the apartment / house
Square feet   Square meter
How did you know about us?

Please select the service you would like to order in the following:

Please select the time slot:
Morning shift (9:00a.m. to 1:00p.m.)
Afternoon shift (2:30p.m. to 6:30p.m)

Frequency :
Daily 3 times a week 2 times a week
Weekly Bi-Weekly Monthly

Any preference on the day?
Mon Tue Wed
Thur Fri Sat


New Customer please select the service you wish to subscribe:
Number of Service Price Average price per visit
       1 time $400 $350
(First Service Discount)

Existing Customer please select the service you wish to subscribe:
Number of Service Price Average price per visit
       1 time $400 $400
       5 times $1,700 $340
       10 times $3,300 $330
       15 times $4,800 $320
       *20 times $6,200 $310
(Special Package Discount)

Remark : Each cash coupon will be valid for 6 months start from issue date. All coupons are non-refundable and non-transferable.


Will you leave key? Yes    No

Do you need ironing service? Yes    No

Any pets at home? Yes    No

Any other special request?


Please select the commence service date:


List of cleaning priorities, if any


*Payment Terms: Deposit to bank account    Cheque


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