Name:^*

Address:^*

City:^*

State:^*

Zip:^*

Telephone:^*

E-mail Address:

Date of Service:

Select the types of windows you have: Standard windows French windows

  Picture windows Storm windows

How do you want them cleaned? Inside/outside Just outside

  Just inside Other

Do you have screens to be removed and cleaned also? Yes No

Do your windows need special cleaning for any reason? For regular maintenance Water spotted Film or soot from fire Post-construction drywall residue Moisture in the chamber between the panes of glass Seasonal cleaning Tobacco smoke film Extra dirty outside Paint on them Other

How many stories is your home? 1 story 2 story 3 or more