First Name *

First Name

Last Name

Real Phone number *

(###)

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Preferred Date *

MM

DD

YYYY

Preferred Time *

To book a last-minute appointment, please note that I require a minimum notice period of 4 hours in advance.

Hour

Minute

Second

AM PM

I’m prepared to submit info for screening *

Ensuring your privacy and safety is my utmost priority. (Options below)

E-mail me your photo ID with a Picture of yourself

LinkedIn URL with a picture of yourself

Require two references from two independent companions, who have a website, a Twitter presence, their ad on Tryst, and email or phone number for contact purposes, and whom you have seen within the last 6 months, along with a picture of yourself.

*

Thank you for submitting a booking form. Please note that any forms containing inappropriate language or content will not be considered. Simply click submit below and I will be in touch with you as soon as possible