Companion Registration Form

This registration form is for companions who want to be listed on this website. To be listed, please fill in the form below. All entries are reviewed after submission and, if needed, edited to fix mistakes. We reserve the right to delete any entry that does not conform to our terms and conditions. Please review the terms and conditions and the companion rules before proceeding.

Contact & Login (Confidential)
E-Mail Address:
Repeat E-Mail:
Password:
Telephone:
Enter your e-mail address and choose a password. You will use them in the future to login to your account and make modifications to your profile 

 
Personal Profile
First Name:
Last Name:
Sex:


Age:
Enter your personal information above. Note that your last name and telephone number will not appear as part of the listings on our website to protect your security and privacy

Your Address (Confidential)
Street:
City:
State/Province:
Country:
Postal Code:
Specify your address in the fields above

 
Restrictions
Gender Restriction:



Age Restriction:





Specify the gender and ages of the people you are willing to accompany

Companion Profile (select all fields that apply)
Specialties:  
Activities of Interest:  
Lifestyle Traits:  
Dress Styles:  
Languages Spoken:
list languages you speak, each on a separate line
 
Cities/Areas Served:
These are the keywords on which users search. If you list 'New York', and the user searches for 'New York', then your listing will be displayed. Do not make spelling mistakes and write only one city/area per line
 
Description and Details:
write a description of yourself (what type of person you are) and provide details of what you can offer someone who chooses you as a companion. Users will likely choose a companion based on these details, so the more interesting you sound, the better chance you have
 
Rate:
How much do you charge per hour and per day? Include currency
  Hourly:     Daily:
Providing Transportation?
select 'Yes' if you will be using your own car to provide transportation
 

Photograph:
upload a clear headshot digital photo of yourself. While not mandatory, a photo is highly recommended if you want to get a good response
 

I certify that I have read the license agreement and the Companion Rules document and that I agree with the terms and shall abide by the rules.



 

    

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