Client Application for Services

Come align with a company that cares.

Client Application for Services

1. Business / Facility Name*

2. Contact Person*

3. Phone

3. Email*

4. Site Address*

5. Type of Facility (check all that apply)

Senior Community

Office Building

Retail Space

Church or Religious Facility

Other: _____________

6. Type of Facility (if you chose other)

7. Number of Units / Suites / Floors

8. Approximate Square Footage:

9. Preferred Cleaning Schedule

Once a Week

2x / Week

Daily (M–F)

Other: ___________

10. Preferred Cleaning Schedule (if you chose other)

11. Preferred Time of Day

Morning

Afternoon

Evening

Overnight

Flexible

12. What areas do you need cleaned? (check all that apply)

Common Areas

Bathrooms

Kitchens / Breakrooms

Offices / Desks

Lobbies / Entryways

Hallways / Stairwells

Trash Removal

Disinfection / Sanitization

13. Do you have any special requests, sensitivities, or access needs? (e.g., fragrance-free products, keycard access, elevator codes)

14. How did you hear about us?

Referral

Instagram

Website

Flyer

Other: ___________

15. How did you hear about us? (if you chose other)

14. Anything else you’d like to share with us?

📬 After submitting, you’ll receive a confirmation email — if you don’t see it, check your Promotions tab.

Thank you for your interest in partnering with Nationwide Cleaning Co. Please complete the form below so we can better understand your space, your needs, and your expectations.

Please fill out the form below, and we’ll reach out if it’s a good fit.

Book Your Clean

Currently serving Atlanta and surrounding metro areas only.
If you're unsure whether your location qualifies, feel free to message us before booking.

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