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Your Details for admin purposes only
Title:	Mr Mrs Miss Ms	Name:
Company Details
Company Name*:		Web Site:	www.
Brief Details: (Things you might want to include may be special offers, the areas you cover, training details and qualifications, etc)	You have characters left.
Contact Details
Address 1:		Post Code*:
Address 2:		Email*:
Address 3:		Phone Number*:
Town/City*:		Mobile Number:
Extra Details
Year Established:		Number Of Staff:
Minimum charge (£):		Work Type?:	Commercial Domestic Both
Moneyback Guarantee?:	No Yes N/A	Days open per week?:	0 1 2 3 4 5 6 7
Do you accept cash?:	No Yes N/A	References Available?:	No Yes N/A
Do you accept credit card?:	No Yes N/A	Free Site Survey?:	No Yes N/A
Do you accept cheque?:	No Yes N/A	Are You Fully Insured?:	No Yes N/A
Do you accept credit account?:	No Yes N/A	Fully Trained Staff?:	No Yes N/A
Cleaning Types (max.6, choose 'No more to add' if less than 6)
Main Service*:	Choose service type Builders Cleaning Car Valeting Carpet Cleaning Carpet Protection Chewing Gum Removal Commercial Cleaning Computer Cleaning Conservatory Cleaning Curtain Cleaning Domestic Cleaning Drain Cleaning Fire Restoration Flood Restoration Hardfloor Cleaning Hardfloor Restoration Leather Cleaning Leather Restoration Office Cleaning Oven Cleaning Patio and Drive Cleaning Trauma Cleaning Upholstery Cleaning Upholstery Protection Window Cleaning Abseil Window Cleaning Pure Water Window Cleaning Traditional	Additional Service 2:	Choose service type Builders Cleaning Car Valeting Carpet Cleaning Carpet Protection Chewing Gum Removal Commercial Cleaning Computer Cleaning Conservatory Cleaning Curtain Cleaning Domestic Cleaning Drain Cleaning Fire Restoration Flood Restoration Hardfloor Cleaning Hardfloor Restoration Leather Cleaning Leather Restoration Office Cleaning Oven Cleaning Patio and Drive Cleaning Trauma Cleaning Upholstery Cleaning Upholstery Protection Window Cleaning Abseil Window Cleaning Pure Water Window Cleaning Traditional
Additional Service 3:	Choose service type Builders Cleaning Car Valeting Carpet Cleaning Carpet Protection Chewing Gum Removal Commercial Cleaning Computer Cleaning Conservatory Cleaning Curtain Cleaning Domestic Cleaning Drain Cleaning Fire Restoration Flood Restoration Hardfloor Cleaning Hardfloor Restoration Leather Cleaning Leather Restoration Office Cleaning Oven Cleaning Patio and Drive Cleaning Trauma Cleaning Upholstery Cleaning Upholstery Protection Window Cleaning Abseil Window Cleaning Pure Water Window Cleaning Traditional	Additional Service 4:	Choose service type Builders Cleaning Car Valeting Carpet Cleaning Carpet Protection Chewing Gum Removal Commercial Cleaning Computer Cleaning Conservatory Cleaning Curtain Cleaning Domestic Cleaning Drain Cleaning Fire Restoration Flood Restoration Hardfloor Cleaning Hardfloor Restoration Leather Cleaning Leather Restoration Office Cleaning Oven Cleaning Patio and Drive Cleaning Trauma Cleaning Upholstery Cleaning Upholstery Protection Window Cleaning Abseil Window Cleaning Pure Water Window Cleaning Traditional
Additional Service 5:	Choose service type Builders Cleaning Car Valeting Carpet Cleaning Carpet Protection Chewing Gum Removal Commercial Cleaning Computer Cleaning Conservatory Cleaning Curtain Cleaning Domestic Cleaning Drain Cleaning Fire Restoration Flood Restoration Hardfloor Cleaning Hardfloor Restoration Leather Cleaning Leather Restoration Office Cleaning Oven Cleaning Patio and Drive Cleaning Trauma Cleaning Upholstery Cleaning Upholstery Protection Window Cleaning Abseil Window Cleaning Pure Water Window Cleaning Traditional	Additional Service 6:	Choose service type Builders Cleaning Car Valeting Carpet Cleaning Carpet Protection Chewing Gum Removal Commercial Cleaning Computer Cleaning Conservatory Cleaning Curtain Cleaning Domestic Cleaning Drain Cleaning Fire Restoration Flood Restoration Hardfloor Cleaning Hardfloor Restoration Leather Cleaning Leather Restoration Office Cleaning Oven Cleaning Patio and Drive Cleaning Trauma Cleaning Upholstery Cleaning Upholstery Protection Window Cleaning Abseil Window Cleaning Pure Water Window Cleaning Traditional
		Want to see another service type here?
Memberships/Associations
NCCA?: i	No Yes N/A	BICSc?: i	No Yes N/A
APWC?: i	No Yes N/A	Want to see another membership/association here?

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