Screening and Booking Form

Screening and Booking Form

Read Before Filling Out the Screening and Booking Form! For my safety and yours, verification is necessary. It is required to complete the secure screening form in order to schedule our date. All new friends, your screening requires a photo of your drivers license, proof of place of employment like pay stub, and a selfie with you holding a piece of paper with today's date written on it. If you have references, they need to be reputable. I do not accept skipthegame. Do your homework with your reference information. Email and website (which can be P411 or Tryst) is required. If you can not find her, neither can I so she would be invalid. The information given is kept private, confidential, and used strictly for the purpose of verification. The screening process is handled with the utmost discretion. Upon the completion of the verification process, this form will be deleted. If you provide a selfie but do not provide your drivers license, proof of place of employment and/or references, I will simply delete your form immediately and you will not be contacted. Please be patient with me responding. Weekends are almost always unavailable and will get back with you as soon as possible.
About You and Contact Information
Your Real Full Name*

First NameLast Name
E-mail Address *
example@example.com
Personal Phone Number (VoIP Not Allowed)*
Resident City and State*
Age*
Ethnicity *
Occupation *
Company
To ALL New Friends, Your Screening REQUIRES a Photo of Your Drivers License, Proof of Place of Employment like Pay Stub and a Selfie with You Holding a Piece of Paper with Today's Date Written on it.

*
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Helpful Companion References

References are active reputable providers you have seen recent. I need her name, link of her website and her email address. Do your homework! If you do not provide the information, the reference would be invalid.
Reference 1
Reference 2
Appointment Details
Preferred Date/Time*

MonthDayYear
Same Day Date Extra
Hour MinutesAM/PM Option
Preferred City Location*
Preferred Length*
Which specific website or ad did you find me at?*
Cancellation Policy: I have read and agreed to your cancellation policy.*

YesNo
If you do not fill out this form completely for verification, the form will simply be deleted. Double check and make sure you provided everything that is needed for a near future date. Thanks!
Please verify that you are human*
Should be Empty: