EmailMe Form - Confidential Screening Request

Full name: *

Email: *

City and state you reside: *

Phone (please no "burner", google voice, or pre-paid #'s): *

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

I will never contact you without your permission.

Age: *

Ethnicity:

Requested date: *

MM / DD / YYYY

Requested time 10AM-10PM *

Start time before 8PM

Location Preference: *

For local engagements of 4 hours or longer, no travel fee is required.

Length of visit: *

Please provide at least one of the four screening options:

Option 1: Personal Verification

Your government-issued ID (photo, full name, DOB, city, and province or state must be visible).

If the file is too large, please use my proton email.

A frontal selfie/photo of you.

If the file is too large, please use my proton email.

Option 2: Professional Verification

I will never email or call you here without your permission. I use a dummy email that is not associated with my Dev profile if any follow up is needed.

Work email and or number
Linkedin or company website

I will never email or call you without your permission. I use a dummy email and number that is not associated with my Dev profile if any follow up is needed.

Option 3: 2 Provider References

information: email and active website or X:

Reference 1
Reference 2

If it has been over a year, it might be better to use another option.

Option 4: Established social media accounts

information: email and active website or X:

Facebook
Instagram

I will request to follow you using one of my discreet dummy accounts, once verified, I will unfollow you.

Tell me a little about yourself (optional):

Photo: (optional but appreciated):