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GET CONNECTED

Please fill out this form to its entirety. A deposit must be accompanied by a submitted form to confirm our encounter.

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Full Name*

Age*

Email*

Phone*

City*

Which site did you find me?*

How do you wish for me to contact you?*

Phone

Email

Desired date and time*

Month

Day

Year

Time

:HoursMinutes

Length of desired encounter*

na*

Incall

Outcall

FMTY

Attach selfie picture*

Attach photo ID*

How would you like to send deposit?*

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Any additional question?*

You understand that I require a discreet non-refundable deposit for all encounters

You understand that my rates are non-negotiable

Until next time,

Bling

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