Contestant
Information

Important Giveaway Reminders

Please fill out the form below to the best of your ability. We do not sell, exchange, or give away your personal information to any third party companies. All information is kept private in our database and is only used for newsletter notifications in the form of electronic mail. Please be sure to check the

'Subscribe me to your Newsletter.' box to be informed on our monthly giveaway winners. An email notification will be sent on or before the 5th of each month announcing the prior months winner. If we are unable to get ahold of you, another winner will be selected. Good Luck to all contestants whom apply!

Contestant Application for Services

Thank you for taking the time to apply to our free house cleaning giveaway! Please be advised this service is only available to Residential parties only, we do not offer this service on a commercial level.

Contestant Information

First name

Last name

Yes, subscribe me to your newsletter.

Phone

Birthday

Month

Day

Year

Multi-line address

Country/Region

Address

Address - line 2

City

Zip / Postal code

Scheduling Your Cleaning

First Selection for Appointment

Date and time

Month

Day

Year

Time

HoursMinutes

Second Selection for Appointment

Date and time

Month

Day

Year

Time

HoursMinutes

Residence Information

How long ago was this residence professionally cleaned? What are the areas that need the most attention? (In order of importance).

Will you be available during the cleaning? If no, please leave instructions on how we can open/close/secure your home.

Are you Allergic to any Cleaners or Cleaning Chemicals?

How did you hear about us?

Feel Free to Attach Files (Not Required)

File upload

By signing this form, I confirm that I am the authorized person who will be receiving cleaning services if I am selected as the winner of the giveaway contest.

Authorization for Services

Signature

Signature field is empty.

Today's Date

By checking this box I am confirming that I am 18 years of age or older when submitting this form and a current resident of Oregon and/or Washington (states).

By checking this box, I have read the Terms and Conditions of this Housecleaning Giveaway and understand the conditions therein. I agree to these Terms along with the Terms of the Service that will be provided to me for free.