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Sample Form: درخواست نظافت منزل

متراژ، نوع نظافت، زمان و دسترسی — قیمت بر اساس همین‌ها اعلام می‌شود.

10 questions · Free up to 50 responses a month

Print-ready Word and PDF files — free, no sign-up.

About this template

“درخواست نظافت منزل” has 10 questions; 6 are required and 4 optional. Question types: Yes / No (2), Short text (1), Mobile number (1), Postal address (1), Slider (1), Single choice (1), Multiple choice (1), Date (1), Dropdown (1). 12 ready-made options across 3 choice questions, all editable in the online version.

In the online version of this template

  • Mobile numbers are validated against the Iranian number format.
  • Dates are picked and stored on the Jalali (Persian) calendar.

Questions in this template

  1. 1.

    نام و نام خانوادگی *

    (Short text)
  2. 2.

    شماره موبایل *

    (Mobile number)
  3. 3.

    نشانی *

    (Postal address)
  4. 4.

    متراژ

    (Slider)
  5. 5.

    نوع نظافت *

    (Single choice)
    • معمولی
    • عمیق
    • بعد از بنایی
    • اثاث‌کشی
  6. 6.

    خدمات اضافه

    (Multiple choice)
    • شست‌وشوی پرده
    • یخچال
    • فر
    • پنجره‌ها
    • فرش
  7. 7.

    تاریخ *

    (Date)
  8. 8.

    بازه *

    (Dropdown)
    • ۸ تا ۱۲
    • ۱۲ تا ۱۶
    • ۱۶ تا ۲۰
  9. 9.

    حیوان خانگی دارید؟

    (Yes / No)
  10. 10.

    مواد شوینده دارید؟

    (Yes / No)

Printable version (Word & PDF)

  • For filling in on paper, signing and filing by hand
  • Edit the Word file any way you like
  • Collecting and typing up the answers is up to you

Online version on Porsino

  • Answers are collected and organised automatically — no retyping
  • National ID, mobile number and dates are validated instantly
  • Ready-made reports and charts, plus Excel export in one click
  • Share a link or QR code — it works on mobile too

How do I use this template?

  1. Sign up for Porsino for free; no bank card needed.
  2. In the panel, open “Templates” and choose “درخواست نظافت منزل”.
  3. Change the questions as you like, publish the form and send the link.
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