The Green Mop ®

Eco-Friendly Residential/Commercial Cleaning Company

The Cleaning Order Form

        New Clients Form to Schedule your cleaning

      1.         Your Name               (required)

      2.         Email address           (required)

      3.         Home Address         (required)

      4.         Phone number         (required)

      5.         If gift certificate or coupon, what is your number(s)? 


      6.         If coupon, how many coupons did you purchase (only one per home - but you can buy gifts ?     

      7.    What days of the week do you prefer your cleaning to be on or it doesn't matter?  Do you prefer mornings (8-12:30) or afternoons (12:30-4)?


      8.         Which do you live in: single family home, townhouse, apartment, condo (required)

      9.         How large is your home (approximate square feet - check  

     10.      How many bedrooms are in your home?                    

     11.      How many bathrooms are in your home?                   

     12.      How many total rooms do we need to clean?            

     13.      How many floors will they be cleaning?                      

     14.      On a scale of 1 - 10 ("1" being the dirtiest) what rating would you give your home?

     15.   On a scale of 1 - 10 ("1" being the tidiest) what rating would you give your home?

        16.  How would you like to schedule your appointment:

          schedule yourself by using the "Genbook" button located on our front page
 Call me at my number above
 Email me at my address above

       Call us at 703 647-9094 or 703 892-2828 

       Or just email us - or

17.      If you have pet(s) - what type and how many?


            18.  Do you have children and how many people live in the household total?


           18.      Parking in your neighborhood. Is it by meter? Two hour zone? Or can we park on your property?


      19.      Type Cleaning Needed:
    "one time" cleaning (move in, move out, etc)
    weekly cleaning service 
    biweekly service 

         every 3 weeks service

         monthly service
    infrequent service

     20. Payment/Deposit for additional services or additional time.  You can pay or leave a deposit on our web site - see credit card payment page.   Or payment by check is fine too at the time of service.  Note below Credit Card?  Check?  Deposit to be left, if not there at completion of service? Based on size - deposits range from $140, $170, $200, $260.


          21. Access to your home?  Will you be there?  Or leave a key, etc?

         22.  Anything else - special requests, etc. we should know about?