Alina's Reservation Form

Alina's Reservation Form

To Schedule an Appointment you are required to fill out this form in advance. All questions must be answered. Your request will be responded to within 24 hours or less.I only ask for your personal information since my safety is of the utmost importance and it is required for the screening process. For your comfort and security the appointment request form is an SSL encrypted page that ensures secure transmission of your information. The information comes directly to me, Please be concise in your responses and be assured that all information will be held in the strictest of confidence. I am an extremely discreet person and expect the same of you.
Is this a reservation for my 90 minute massage? *	Yes No
What is your name? *
What is your mobile number or best contact number to reach you at? *
What is your email address? This is the only way that I will respond to your request. Therefore it is very important that you type in your entire email address. Leaving out any part will make it impossible for me to reach you:-) *
In what City do you reside? *
In what City would you like to meet? *
Would you like to use my incall location in Seattle?
If requesting for an outcall at what address would you like to meet?
When would you like to meet? Specific Date:-) *
At what time of the day would you like to meet? Please do not leave a general time. Offering a specific time is VERY important in determining our appointment:-) *
How much time would you like to spend together? *
Please list at least one reference whom you have seen in the past. *** (a reference is a provider you have seen in the past) If you do not have one reference contact me for further screening:-) *
Please list your references website and email address:-)
How did you find Alina Angely? *
Is there anything else I should know? *