Booking form

* Required Field

About You-Please include your full name!!

Name: *
Age: *
City: *
Occupation: *
Company: *

Contact Information

Email: *
Phone: *
calls only: *
best time to call-: *

Appointment Details-Please have your dates confirmed!!

Preferred Dates/Times: *
Preferred Location: *
Preferred Length: *
Outcall Location:
Special Request(s):
Any Likes or Dislikes:
Are you a resident or traveler:

Screeing is imperative for both our safety. I'm an established and trusted escort companion and will hold all information given with the utmost discretion. Once you leave my company I no longer know you, until you contact me again. All new clients please fill out this form then call. Please note- any forms without a confirmed date/time, without picture id, or a full name included will be ignored, the email reported as spam, and the phone number blocked.