BOOKING FORM

Full Legal Name (P&C)

Age Age20-3030-4040-5050-6060+

Phone Number (include country code)

Email Address

Company Name & Job Position

Links - This should be a link to a publicly identifiable profile.

How long are you booking me for? How long are you booking me for? 2 hours - public date (SGD400)2 hours (SGD1000)3 hours (SGD1400)4 hours (SGD1700)8 hours (SGD2300)16 hours (SGD3200)24 hours (SGD4500)

Share with me all your availability e.g. weekends after 2pm, Fridays after 5pm etc.

How did you find out about me? E.g. Google, Twitter

Message: Introduce yourself! What are you passionate about? What is a pet peeve you have? Your boundaries? I'd also love to hear how you wish to spend our time together. Feel free to include additional questions you may have (reminder that respectfulness is a turn on for me). If you're booking me for more than 3 hours, share with me what you'd like to do together! x

I require extra discretion. (This only applies if you are someone of prominence or if you have friends & family who may be present at the location of our date) I require extra discretion. (This only applies if you are someone of prominence or if you have friends & family who may be present at the location of our date) Yes No

Are there any physical or mental ailments I should take note of? I do not discriminate but this will be helpful when screening and meeting.

Reason for discretion

References, if any, from fellow colleagues in the industry

Would you like to be included in my newsletters? Would you like to be included in my newsletters? Yes No

I am DDF (drug and disease free). I am DDF (drug and disease free). Yes, and I have verifiable proof. Yes No

I have read, understood, and agree to comply and be bound by the terms and conditions. I have read, understood, and agree to comply and be bound by the terms and conditions. Yes No

I declare that everything above is accurate and true. I declare that everything above is accurate and true. Yes No