UEX Client Booking / Sign-Up Form
Register Below
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Instagram
*
Instagram Handle (if applicable)
Preferred Method of Contact
*
Please Select
Text
Email
Call
Booking Intent
Please select your booking intent
Areyou interested in:
*
Companion Experience
Event Escort
Travel Companion
Something Else (please describe below)
Please describe
*
Date(s) or time frame you’re considering?
*
Type of experience you’re envisioning (Dinner? Gala? Business event? Travel?)
*
Please Describe.
Duration of experience (2 hours, full day, overnight, weekend?)
*
Do you already have a specific Companion in mind?
*
Yes
No
Vibe Check
Lets check the vibe!
What type of vibe are you seeking in a Companion?
*
(e.g., sophisticated, flirty,low-key, outgoing, intellectual, etc.)
What’s most important to you?
*
Discretion
Appearance
Conversation
Chemistry
Any preferences we should know?
*
(height, style, body type, personality, etc.)
Are you open to being matched with a Companion who is a great fit for your desired experience, even if they are not the one you originally selected?
*
Yes
No
Anything else we should know before your consultation?
*
Submit
Should be Empty: