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Screening Form
Profile Identifier
First Time Visit?
*
Yes
No
First Name
*
Birth year
*
e.g., 1978
How would you like to screen?
*
Reference from an established an active provider
Employment Verification
Professional Linkedin Profile
Established And Recent Review History (e.g. P411 or TER)
Work/Professional Email
Selfie + ID
Other
How would you like to screen?
*
Reference from an established an active provider
Employment Verification
Professional Linkedin Profile
Established And Recent Review History (e.g. P411 or TER)
Work/Professional Email
Selfie + ID
Other
Work Email
enter your work email here
Submit Screening
*
Please provide the relevant link or details necessary for verification. The more complete the information you provide, the easier it will be to process your screening promptly.
Online Handle (ter, hx, pdelights, TNABoard, etc)
*
Share the Username and list the website, or share the URL for your established profile
simplebookings@protonmail.com
Email me at this address using your work email
Work Email
*
e.g., intel@example.com
Linkedin Profile
*
Share a link to your established LinkedIn Profile. Your Linkedin needs to have a visible picture attached, a work history, and a good amount of connections or it will not be accepted
Recent Selfie
*
Browse Files
Drag and drop files here
Choose a file
Upload a recent selfie holding up 2 fingers. No glasses/headgear. Do not let your fingers block your face.
Cancel
of
Recent Face Selfie (*Not Required, But Appreciated)
Browse Files
Drag and drop files here
Choose a file
Recent selfie holding up 2 fingers. No glasses/headgear. Do not let your fingers block your face.
Cancel
of
Provider's Phone Number
*
Please enter the provider's Phone Number
Format: (000) 000-0000.
Provider Reference
*
Enter the name or URL of the established and active provider you'd like to use as a reference. Please note that I will contact them and ask them if you are safe to see
Acknowledgement and Consent
*
Reconocimiento y consentimiento
*
स्वीकृति और सहमति
*
الإقرار والموافقة
*
Email (Optional)
example@example.com
Additional Booking Details
Include any additional details you'd like to add or share
Phone number
*
* Please provide a genuine, currently active phone number. VoIP, TextNow, temporary, or otherwise unverifiable numbers may not be accepted.
Format: (000) 000-0000.
Submit
Should be Empty: