I hope you understand the need of discretion on both our parts. Please fill out all fields completely, you may also copy the form and e-mail it to me if you feel more comfortable that way. The information is immediately discarded right after our date. Confidentiality agreements are offered for gentlemen with rather high profile in their field.

What is your full legal name?
What is your age?
What is your occupation title?
What company do you work for?
What is your work phone number - general switchboard with extension?
What is your mobile or alternate phone number for best contact?
What is your email address?
What city do you reside in?
What city would you like to meet in?
What address would you like to meet at?
What is the date of required appointment?
What time would you like to meet?
How long would you like to spend together?
How would you like to pay your deposit? Wire Transfer
Pay Pal
Money Order
How would you like to pay the remainder of Tess' fee? In Person
Wire Transfer
Pay Pal
Money Order
How did you find Tess?
Reference: Independent Escort you saw in the past Name

Anything else Tess should know: (if you frequent public review boards please include which with your handle as well as your hobbies, likes and dislikes...)



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