EmailMe Form - Screening/ Contact Form

1.) Name *

2.) Email *

3.) Phone #

### - ### - ####

4.) Board Handle/ Username

( If you are a member of any message/ review boards
TER/ ECCIE/ BGFE..... etc )

5.) Provider References

Please provide the Name/ Website address along with contact information for at least TWO of the Lovely Ladies you have most recently enjoyed time with. Please include the approximate dates you saw them.

Reference # 1 *

Reference #2 *

Reference # 3 (optional)

6.) Screening Service (preferred)

If you are a member of Preferred 411, TER White-list, or Rs2k please enter your
member details for screening.

Newbie, or not frequent enough to have reliable references?

Generally I do not prefer to see newbies....

However,
if you are a gentleman & have educated yourself on the proper way to speak to / treat a lady of leisure sometimes I may make exceptions.

Newbie screening would require you to be willing to give up more personal information to ensure my safety.

Info such as:

Full Name,
Proof of employment, - ( I will verify)
city which you reside in,
& identification.

If you need this type of screening, and feel comfortable with having your information verified through a screening service like intelius, etc.. please let me know your name, city of residence and employer to start with.

We will continue via phone conversation after.

7.) City/ State for rendezvous *

9.) Desired Date/ Time (mm/dd/yy)

If you are unsure of exactly when you would like to get together you can leave this blank for now
& We can figure it out together after screening. ;)

8.) Incall/ Outcall/ Outing? *

10.) Time you would like to enjoy together

Please let me know if we will be meeting for a Full hour, 1 1/2 hour, 2 hour, 3 hour, 4 hour, Overnight, full day, or Weekend rendezvous *

Use this field to include any clothing/ lingere/ or special requests you have for our date.

I am very accomodating & take pleasure in helping you fulfill your fantasies, so please don't be shy!

( Please keep requests "PG". I do not respond to requests for illegal activities )