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Book a Date with Me
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Are you ready for paradise?
First Name*
Last Name*
DOB*
Ethnicity
Email*
Phone*
Linkedin or business website
Desired date and time*
Incall
Outcall
FMTY
Length of Date*
Where did you find me?
Provider Reference #1
Provider Reference #2
Are you a member of any boards and/or screening websites? (P411, Private Delights, etc)
YES (please list)
NO
1. You understand that I require a discreet non-refundable 20% deposit for all encounters.
2. You understand my rates are non-negotiable.
Please introduce yourself & tell me a bit about you. What is your ideal date? Likes, dislikes? Any health concerns? What is missing from your life? All dates/sessions are tailored to fit you! (Please no vulgar language.)
Please provide a copy of your photo ID (passport or drivers Iicense):You may feel free to blur your address but please have the image of your face displayed.
Upload File
Upload supported file (Max 15MB)
Accept SMS?
YES
NO
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