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Your Contact Information
E-Mail Address: Telephone:
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About You
First Name: Age:
Last Name: Sex:

 
Where Do You Live
Address 1: State:
Address 2: Country:
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Tell Us About Yourself
In a paragraph or 2, describe yourself to us. Tell us about your job, education, and personality. Tell us what you like and what you don't like.

 
Tell Us What You Want
Please tell us what we can do for you. List everything you would like us to provide for you and everything you would like to do.

 
Payment (in US Dollar)
Please tell us how much you are willing to pay (in US dollars) for our services. Specify the maximum you are willing to pay, and the ideal amount you would like to pay. We provide high quality service, but some services are affected by the price (e.g. hotels for travellers)
Ideal Amount: Maximum Amount: 

 
Quality of Service
What quality of service are you accustomed to? For instance, if you are going out to dinner, what type of restaurant would you choose, or if you are travelling, what type of hotel would you stay in?
 

 

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