Fantasys Client Screening

I am from ?:	United States Residents International Countries
First name:
MI:	If you do not have one, please enter a space by pressing the spacebar.
Last name:
Date of birth:	MM/DD/YYYY (We appreciate your interest; however, we do not service the 29 and under market)
City of residence:
State of residence:
Home phone:	555-555-5555 [*No cell phones or work phones*] Your home phone will NOT be called unless YOU request otherwise. This is purely part of the verification process.
Cell phone:	Format: 555-555-5555
Work phone:	Format: 555-555-5555
Email address:
Employer:	"Self Employed" is not an acceptable answer, state the name or nature of the company.
Employer city:
Employer state:
Contact instructions:
Provider reference 1:
Provider reference 2:
Meeting date and time:
Meeting location:
Your height:	In inches
Your weight:	In pounds
Hair color:
Eye color:
If you don't know which websites the following username requests are for leave them blank.
TBD Username:
TER Username:
Naughty Reviews Username:
Date check:
Room service 2000:
Provider 411:
How did you find us:
Have you seen a fantasys escort before:
Do you know the rules:
Which escort are you interested in seeing:
Security code: