Name *

First Name

Last Name

Phone number *

Country

(###)

###

####

Preferred Length of Date? *

Dates 3 hours and longer must include social time in a public setting (a shared meal, cocktails, fun outing, etc).

1 hour/$500

1.5 hours/$800

2 hours/$1,100

3 hours/$1,400

4 hours/$1,700

5 hours/$2,000

Overnight Date/$2,500 (12 hours) *minimum requirement for FMTY dates*

Full day/$3,000 (24 hours)

Extended date/$4,000 (48 hours)

What day would you like to meet? *

MM

DD

YYYY

What time would you like to meet? *

Hour

Minute

Second

AM PM

Confirmation *

Have you read my etiquette page in its entirety?

Yes, I read your etiquette page and familiarized myself with the written expectations