Private Men Profile Form - Samantha X After Dark

Personal Details

Confidential - for our eyes only.

First Name:*

Surname:*

Mobile Number:*

Email Address:*

Private Men Profile

Your public profile.

Escort Name:*

Age:*

Height (cm):*

Weight (kg):*

Body Type:*

Eye Colour:*

Hair Colour:*

Smoker?:*

Yes
No

Tattoos?:*

Yes
No

Orientation:*

Country Of Residence:*

State:*

City:*

Nationality:*

Place Of Service:*

Incall
Outcall
Incall and Outcall

About Me:*

This is your welcome text to clients. Include details about yourself that you would like potential clients to know, i.e. your personality, likes, hobbies etc..

Rates:*

Please include incall and outcall rates as applicable. Please note: you can have the same rate for both if you wish.

Payment & Additional Information:*

Let your clients know information about your booking preferences and what payment forms you accept.

Services:*

Please list the services you offer. *Please note: Victorian escorts are not allowed to list their services, please insert N/A.

Tours:*

Please list any upcoming tours.

Availability:*

Let your clients know which days and times you are available.

SWA Number (Victoria Only):*

Please insert N/A if you are not escorting in Victoria.

Contact & Social Media

For clients to contact you.

Mobile Number:*

Email Address:*

Website:

(optional)

Twitter:

(optional)

Instagram:

(optional)

Snapchat:

(optional)

Facebook:

(optional)

OnlyFans:

(optional)

Please upload your current drivers licence (ID):*

Or upload a selfie with a sign stating your escort name, phone number and today's date.

Max. file size: 512 MB.

Please upload your professional photos:*

Maximum 8 images

Drop files here or

Max. file size: 512 MB, Max. files: 8.

Authorisation

Social Media Authorisation:*

I give permission for Samantha X After Dark to use my professional photos and public profile information on their Samantha X After Dark Twitter & Instagram accounts to help promote my profile.

Yes
No

Terms & Conditions:*

By choosing this you are agreeing to the Terms & Conditions set out in the Private Men Information Sheet.

I agree to the Terms & Conditions.

Phone

This field is for validation purposes and should be left unchanged.