Longer dates always take priority in my very busy schedule… Full Legal Name * First Name Last Name Age * Email * Phone * (###) ### #### Desired date * MM DD YYYY Desired start time * Do you have any flexibility on dates and times? * Incall/Outcall/Travel? * Incall Outcall FMTY Length of Date * 1 hour 2 hours 3 hours 4 hours 5 hours 6 hours Overnight 14h Overnight 18h 24 hours 48 hours 72 hours 1 week Where would you like to see me? * LinkedIn or business website * http:// Provider Reference #1 * Include the name, email, and website address of someone you've met in the past 6-12 months Provider Reference #2 * Include the name, email, and website address of someone you've met in the past 6-12 months Provider Reference #3 * Include the name, email, and website address of someone you've met in the past 6-12 months Checkbox * 1. You understand that I require a discreet non-refundable deposit for all encounters 2. You understand my rates are non-negotiable 3. You understand that screening is mandatory, and no exception can be made Your Introduction * Thank you! Looking forward to setting something up xx
