Cleaning Services Request Form

In order to get the most out of your cleaning service, please ensure the following items are completed prior to your area being cleaned:

  • Remove all items from countertops
  • Wash dishes and put them away
  • Remove all garbage from the apartment
  • Keep items off of the floor

**Please note that cleaning services may be denied if the residence does not meet health and safety guidelines and/or not prepared appropriately (administrative fees may be assessed if cleaning services were not performed due to standards not being met prior to service).


* Requested by:
* Phone #:
* E-mail:
* Location:
* Room #:

Please check the cleaning services (1 hour of service for $ 42.50):
Shower Room
Tub Room
Toilet Room
Living Room (includes stairs in 2 story suites)
Kitchen (includes stove and microwave)
All Tiled Areas (walls & floors - excluding bathroom floors)
Garbage and Refrigerator


* Please describe the work request in detail:

Submitting a cleaning request automatically authorizes Residence Services Housekeeping to enter your unit at anytime with or without your presence.


The University of Regina collects information under the authority of The University of Regina Act and in accordance with the Local Authority Freedom of Information and Protection of Privacy Act and the Personal Information Protection and Electronic Documents Act for purposes of the administration of the University and its programs and services. By responding to this form, you are consenting to the University of Regina using your personal information. Use of said information is subject but not limited to: future contact regarding your cleaning request.