Elite Companion

Request Date

Screening is required to request a date with me.

If you have no companion references, I will need your legal name and verifiable employment info.

Have a P411 account? Send me a pre-screen or appointment request. (screening takes less time).


If you are not comfortable fiiling out this form, simply email an intoduction of yourself and the required info to:



If I don't get in contact with you within the time frame below, expect that I have found us to not be a good match.

Please allow up to 24 hours on weekdays, and 48 hours on weekends for a reply.

* Required Field
About You
Contact Information
Your Profiles
Appointment Details
Work Verification w/ No Companion References
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