Booking Connections Made Here SCREENING / BOOKING FORM: YOUR DETAILS Full Name: Email: Contact Number: Can you receive texts at this number? YesNo Home City: Have we already met? YesNo How old are you? ABOUT OUR ENCOUNTER What city do you want to meet in? Where are we meeting? IncallOutcallPublic Location Please provide the location name and address if meeting at your location: Date of Appointment: Preferred Time of Appointment: Hr —Please choose an option—123456789101112 : Mins —Please choose an option—00153045 AM/PM —Please choose an option—AMPM Type of session: SocialSensual Type of encounter: —Please choose an option—Impression (up to 2hr)Inception (up to 3hr)Introspective (up to 4hr) Outfit Preference: —Please choose an option—BoudoirGlamourAu NaturaleProfessionalCasual Favourite Refreshment: Preferred Ambiance Music: Suggestions / Special Requests / Questions VERIFICATION 3rd Party Verification Service: If you are a member of a 3rd party verification service, please provide your member handle here. Recent Reference #1: (Must include name, contact info, and website or URL to an active online ad) Recent Reference #2: (Must include name, contact info, and website or URL to an active online ad) Employment Info (if recent references are not available): Company, Title, Website and LinkedIn info By submitting this form I understand that I am expected to provide a minimum 24 hours’ notice if I must cancel. If I fail to provide enough notice, I will be responsible for 50% of the amount due for the time which has been set aside for me. Accept