Application

I don't see new clients unless they have two references and have filled out the application form below.

Without exception, I require all first-time gentlemen to be screened. This is not only for my safety and comfort, but for yours as well.

In respect your privacy, any information conveyed remains strictly confidential. The screening form will be deleted in 48 hours.

Once you have filled out the screening form, I will contact you!

* Required Field

About You

Real First Name: *

Age:

Occupation:

Your Phone Number: *

Your Email: *

First Provider Reference Name & contact info:

Second Provider Reference Name & contact info:

Facebook Page:

Linked In Profile:

Interests:

How did you hear about me?:

What is the answer to the above question?

For your security, your screening profile will be automatically deleted after 7 days.