1

Contact Information Your name and contact details + best way to reach you is required and must be provided before continuing completion of the form.

2

What's your name?* This field is required.Please enter both your first and last name

First

Middle

Last

3

What Is Your Phone Number?* This field is required.Provide a valid phone number that I can reach you at with reasonable ease and effort.

Please enter a valid phone number.

4

Email* This field is required.

example@example.com

5

What Are Your Communication Preferences?* This field is required. Using the drag-n-drop function, arrange the contact methods into an ordered list that ranges from most preferred to least preferred.

6

What Are Your Physical Characteristics?* This field is required.None of this information will be used to disqualify you from booking a session. This information is used for the purpose of validating and confirming your identity during the screening process.

7

Online Presence * This field is required.Provide 1-3 social media accounts by listing your username/chat handle.

8

Would You Like To Upload A Selfie?

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

Browse Files

Sharing a photo of yourself to help validate your information during the screening process is recommended but NOT required. It is optional.

9

Our Rendezvous You will be asked to provide some relevant details and information about the booking.

10

What Is The Date Of The Session?* This field is required.Select the date of the session that you are booking

11

What Time Is The Session?* This field is required.Choose which time you'd like to schedule for the booking

12

Incall or Outcall?* This field is required.Please choose whether you want to come to me (incall) OR if you would like me to travel to your place (outcall).

13

Where is the session located?* This field is required.Please provide a general location such as the city/town or neighborhood. If you feel comfortable, you can give a more specific address.

14

What's The Duration Of The Session? * This field is required.I offer sessions that range in time from 30 minutes to 6 hours as well as overnight stays for both incall and outcalls. Please inquire in the 'additional message' portion of the form for the rates of sessions that exceed 8 hours

15

What type of session?* This field is required.Please specify the type of session you want to book

16

Deposit Policy Heading

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DEPOSIT POLICY

A 20% deposit payment is required to secure the date/time of your booking if the session meets any of the following criteria:

Sessions pre-booked 2+ days in advance

Prior history of NO CALL/NO SHOW bookings and/or general time waster behavior

Out of county outcall sessions

Outcalls to Oak Harbor, Anacortes or Concrete

Image of informative digital business policy flyer

18

DEPOSITS: Which Payment Method Do You Prefer?* This field is required.Use the guide above to determine if you are booking a session that I request a deposit on. If applicable, choose one of the 3 payment options that I accept. Thank you boys!

Cashapp

Venmo

Cryptocurrency (not always an option)

19

Where should I send my deposit payment?

Informational graphic 'Please Send All Deposits Via Cashapp, Venmo or Bitcoin'

20

Where Did You Find Me?* This field is required.

List the website, escort advertising platform, social media platform, etc. where you found out about my services.

21

Do You Have A Message Or Any Additional Comments?

22

TERMS AND CONDITIONS Of Annette Jane's Erotic Companionship, Fetish Therapy & Intimacy Coaching Services* This field is required.The text box below contains is a short scrollable list of the terms and conditions of booking an erotic companionship session with escort, Annette Jane.