Name:                    

  Company Name:

  Address:                

  City:                    State: Zip:

  Phone:                 Email:
 
 Best time to call:
  Morning Noon Evening Anytime

  Items to be cleaned (Please check all that apply):
  Mini Blinds                     Faux Wood Blinds   Real Wood Blinds
  Honeycomb/Duette Shades/Pleated Shades     Vinyl Vertical Blinds
  Fabric Vertical Blinds   Woven Wood Blind Ado Sheers (sheers over verticals)
  Silhouettes (sheer front/Back with fabric vane) Roman Shades/Hobbled Shades
  Luminettes (sheer face with vane connected)
   How many Luminettes do you have?

  Estimate Cleaning Date:
  Within Next 2 Weeks
  Next 2-4 Weeks
  Beyond 4 Weeks

  Additional Comments: