Screening Information:
First time clients, please view my entire web site including expectations page for information to help in the screening process. All
information given to me will remain strictly confidential. I pride myself on my discretion.   All information in
RED must be provided
otherwise I will not be able to process your appointment form.
DISCLAIMER
Money exchanged is for time and companionship only. Anything else that may
or may not happen is a matter of personal choice and personal preference
between two or more consenting adults of legal age, and is not contracted for, nor
is it requested to be contracted for, or compensated for in any manner.
Name
Email Address
How did you find my site?
Have you seen another escort before?
If yes, please provide her email and/or web address so that I may
contact her:
Occupation/Employer*
*This information is mandatory if you
have not seen an escort
Work Number

Contact/Cell Number

City and State you are from
Are you wishing to see me by private invitation?
If yes, please list city
And State
Please note that I do not see anyone under the age of 45
Age
Desired Appointment Date
Alt. Appointment Date
My hours are 10am to 8pm MONDAY through FRIDAY. Appointments
made on a weekend will be subject to a $50 additional fee. 24 Hour
advance notice MANDATORY for checking references.
Desired Appointment Time
Number of Hours you wish to reserve:
Would you prefer Incall (my location) or Outcall (your location)?
Special request regarding your appointment:
Preferred411.com

I am verified & accept Date-Check. Listed in Orlando escorts
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