Name *
Name
I will need to confirm with an ID when we meet.
I will never call or text you unless you tell me this is your preferred form of communication.
Date of birth *
Date of birth
Just like you, I like a teaser. Let me know about your interests, hobbies, likes/dislikes, or just tell me whatever is on your mind.
Companion reference and verification
Please provide the name, email address, and website of two upscale, independent companions you have met within the last year. Also provide any distinguishing features that the companion will recognize (e.g. Nadia will know me as the tall gentleman in cowboy boots).
Verification services
Are you a member of any of these verification services?
If so, please list handles here:
The logistics
What day would you like to meet? *
What day would you like to meet?
Please see the scheduling page on my website for availability information.
What time would you like to meet? *
What time would you like to meet?

After you submit this form, I will contact you via email.  Thank you for your interest!