Please present my consideration discreetly within the first 10 minutes of meeting.

Never make me ask for it, it ruins the moment.

Consideration is for my time and companionship only. If you make me feel uncomfortable at any point I will end our date with a smile on my face.

Full Name:


Phone number:

Proposed Date & Time:

Meeting Duration:

Where would you like to meet?

Screening Method:

Where did you hear about me?