I do respect your reluctance in giving out your personal information, as well as your need to be discreet. Please be assured your information is for verification purposes only. It will be deleted after we meet.

I believe in safe and healthy boundaries, so please don't submit anything that makes you uncomfortable. However, trust is a two way street and I'm very selective in who I see. I need to feel comfortable and at ease, so I can providce the best possible experience in our time together. My personal safety, as well as those I spend time with, is my primary concern. My private in call location is only as safe as I keep it.

I would like to thank you in advance, for your understanding in this important matter. I will e-mail you as soon as I review your informatin, to confirm our appointment. 

I look forward to meeting you soon.



FIELDS MARKED WITH (*) ARE REQUIRED!
 
Last name: (*)
First name: (*)
City of Residence: (*)
State/Country of Residence: (*)
Personal Phone:(*)
Type of Phone?:
Work Phone :(*)
Special Instrutions for verifying work?
Age:
E-mail: (*)
Best time to contact you?:
How should I contact you?:
How did you find me?:
Occupation:(*)
Company Name and City:(*)
Reference from Another Girl? Who?
Appointment day?:
Approximate Time and Length: